Diagnosis of intra-abdominal infections and management of catastrophic outcomes

Intra-abdominal infections are a diverse group of frequently encountered conditions of varying severity with various underlying pathologies. The first part of this thesis focused on the diagnostic work-up of suspected intra-abdominal infections. The diagnosticvalue of commonly used inflammatory markers and the value of contrast enhancement of computed tomography was evaluated in patients presenting with abdominalpain, the predominant symptom of an intra- abdominal infection. Regarding the most common intra-abdominal infection, acute appendicitis, the value of inflammatory markers and the performance of different imaging strategies were assessed.
Furthermore, ascoring system was developed to distinguish simple from complicated appendicitis. The value of C-reactiveprotein and the external validity of adecision tool were evaluated in patients suspected of apostoperative intra-abdominal infection, aseparate entity within intra-abdominal infections.
The second part of the thesis explored different aspects of management of the potential catastrophic outcomes of intra-abdominal infections including the open abdomen and complex abdominal wall defects. The outcome of specialised treatment of one of the most catastrophic outcomes of intra-abdominalinfections, acute intestinal failure, was analysed. Surgical options for the repairof contaminated abdominal wall defects were evaluated and the potential of abiologic mesh was explored.