EARLY DIAGNOSIS AND SURGICAL AND INTENSIVE TREATMENT OF ABDOMINAL SEPSIS

Abstract

Intra-abdominal infections are one of the leading causes of sepsis and mortality in critically ill patients, requiring early diagnosis and an integrated therapeutic approach to reduce progression to multiple organ dysfunction and septic shock. The aim of this study was to review recent evidence regarding early diagnosis, surgical control of the source of infection, and intensive care in abdominal sepsis. A narrative literature review was conducted using search terms related to sepsis and treatment, including studies published in the last five years. The findings demonstrate that early recognition should combine continuous clinical assessment, prognostic scores such as SOFA and qSOFA, imaging studies—especially computed tomography—and biomarkers, with procalcitonin standing out as a useful tool for severity stratification, monitoring therapeutic response, and supporting the safe discontinuation of antibiotic therapy. Early control of the source of infection proved to be the main determinant of prognosis and can be achieved through percutaneous drainage, laparoscopy, laparotomy, or damage-control surgery strategies in unstable patients. Empirical antibiotic therapy should be initiated early, with a preference for short courses once the source of infection has been adequately controlled. Intensive care, including target-guided hemodynamic resuscitation, timely use of vasopressors, and the involvement of multidisciplinary teams, has been shown to have a positive impact on reducing mortality. We conclude that the combination of early diagnosis, effective control of the source, rational antibiotic therapy, and serial reassessments constitutes the most effective strategy for optimizing clinical outcomes in abdominal sepsis.