What Are the Appropriate Procedures for Initial Evaluation of Patients with Suspected Intra-abdominal Infection?
• Routine history, physical examination, and laboratory studies will identify most patients with suspected intra-abdominal infection for whom further evaluation and management is warranted (A-II). • For selected patients with unreliable physical examination findings, such as those with an obtunded mental status or spinal cord injury or those immunosuppressed by disease or therapy, intra-abdominal infection should be considered if the patient presents with evidence of infection from an undetermined source (B-III). • Further diagnostic imaging is unnecessary in patients with obvious signs of diffuse peritonitis and in whom immediate surgical intervention is to be performed (B-III). • In adult patients not undergoing immediate laparotomy, computed tomography (CT) scan is the imaging modality of choice to determine the presence of an intra-abdominal infection and its source (A-II). When Should Fluid Resuscitation Be Started for Patients with Suspected Intra-abdominal Infection? • Patients
