Post-operative peritonitis (PP) is a life-threatening hospital-acquired intra-abdominal infection with high rates of mortality. Diffuse PP remains a challenge for surgeons. Prognosis and outcome of patients are directly related to early diagnosis and prompt intervention. The diagnosis of PP may be difficult because there are no specific clinical signs and laboratory tests to reject or confirm the diagnosis. Atypical clinical features may be responsible for a delay in reoperation. An early diagnosis and prompt treatment is crucial to prevent the development of organ failure and improve the outcome of the patients with PP. The cornerstones in the management of patients with PP are early hemodynamic support, prompt source control and adequate antimicrobial therapy.
Lymphoscintigraphy can be used to select patients with rectal cancer who will be helped by a lymphadenectomy extended to the obturator nodes. However, the concept of the sentinel node cannot be applied to rectal cancer.
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