By vgreene, 8 December, 2020 Perform resection as tx of choice if overt perforation feculent peritonitis 2 3 Use minimally invasive approach if expertise available2 4
By vgreene, 8 December, 2020 Reserve surgical intervention for critically ill those failing medical tx laparoscopic lavage is controversial not 1st line for diffuse peritonitis
By vgreene, 8 December, 2020 Don t limit diet or activity Unrestricted diet preferred by ESCP 4 although AGA advises clear liquid diet for pt comfort 6 bed rest not rec d due to potential to darr general condition4
By vgreene, 8 December, 2020 Consider percutaneous drainage if abscess 3 cmASC ESC 4 5 cm per WSES WSE due to high abx failure rate
By vgreene, 8 December, 2020 Refer pt for surgical intervention if develops s sx of sepsis or systemic inflammatory response 4 5 other hemodynamic instability 4 or fails worsens w non operative tx5
By vgreene, 8 December, 2020 Consider shorter courses of abx when req d 4 day course as effective as 7 days 5 switch to PO as soon as possible2
By vgreene, 8 December, 2020 Reserve abx for immunocompromised pts those w significant comorbidity 1 3 5 6 per AGA also start abx for pts who are frail present w refractory sx or vomiting have CRP 140 mg L or baseline WBC 15x109 cells L have a fluid collection or longer segment of in
By vgreene, 8 December, 2020 May tx uncomplicated dz as outpt2 3 if all are true tolerating PO adequate social network immunocompetent no sepsis or hemodynamic instability no significant comorbidity 2 4 re eval in 7 days per WSES sooner if deteriorating 2
By vgreene, 8 December, 2020 Uncomplicated dz likely inflammatory not infectious may be self limited 1 reserve abx for select pts
