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April 1978

Intra-abdominal Infection and Acute Renal Failure

Author Affiliations

From the Department of Medicine, Indiana University School of Medicine, Indianapolis.

Arch Surg. 1978;113(4):467-472. doi:10.1001/archsurg.1978.01370160125021

• The course of 76 consecutive patients with acute renal failure and severe intra-abdominal infection was reviewed to identify the microorganisms responsible, the factor precipitating reoperation, and prognostic indicators. Peritonitis occurred in 75 patients, 48 of whom had abscesses. Twenty-four patients (32%) survived. Anaerobes and fungi were commonly grown from blood. Gram-negative aerobic blood isolates were associated with the highest mortality. Leukocytosis, physical findings, and fever were factors that prompted reexploration whereas diagnostic procedures played an ancillary role. The finding of specifically correctable conditions at reoperation improved survival (P <.05). Myocardial infarction and disseminated intravascular coagulation affected survival unfavorably whereas hyperalimentation had a favorable influence (P <.05). Aggressive medical, nutritional, and surgical management results in improved survival rates in these patients.

(Arch Surg 113:467-472, 1978)

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