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Abdominal sepsis is a condition in which a patient develops an infection in one of the organs located in the abdominal cavity, such as the appendix, intestine or pancreas. Bacteria from this infection can then enter the patient's bloodstream and travel throughout the body. Rapid diagnosis and treatment with antibiotics, along with surgical treatment in some patients, is required to eradicate the infection. If left untreated, this condition can be fatal. Abdominal sepsis may be a primary, secondary or tertiary infection.
When abdominal sepsis is a primary infection, there is no obvious cause. Small sacs of fluid in the abdomen, called ascites, may become spontaneously infected. Patients with liver disease, such as cirrhosis, are more prone to developing ascites, and are therefore more likely to develop primary infections. Ascites are typically painless, and the only symptom the patient may notice prior to infection is an increase in the size of his abdomen. Although a number of different bacteria may cause the ascites to become infected, E. coli is among the most commonly found in patients with primary sepsis.
Any sort of trauma to an abdominal organ, such as rupture or surgery, may result in abdominal sepsis as a secondary infection. The abdominal cavity, or peritoneal environment, is typically sterile. If an infected organ ruptures, the bacteria from that infection may contaminate the area and lead to sepsis. Rupture due to injury can cause a healthy organ to leak fluid into the abdominal cavity. This fluid can irritate the cavity, triggering an immune response and causing sepsis despite the original lack of bacteria.
Minor operations on patients who do not already have an active infection or serious injury to the abdominal organs are not likely to lead to secondary abdominal sepsis. In cases of greater injury or preexisting infection, however, the risk of sepsis can be greater than 50 percent. Most sepsis cases are of the secondary type.
Tertiary infection only develops after therapy for primary or, more commonly, secondary intra-abdominal sepsis. In these instances, the bacterial infection is persistent despite a proper course of treatment for the original infection. A weakened immune system makes a patient more likely to develop a tertiary sepsis infection. Patients will often develop abdominal abscesses with this type of bacterial infection, and will generally require additional surgical procedures to recover. Severe primary or secondary abdominal sepsis is more likely to result in a tertiary infection than a milder bacterial infection is.