Diagnosis and surgical management of septic peritonitis in small animals: A review.

Abstract

BACKGROUND: Septic peritonitis (SP) is a complex disease with significant morbidity and mortality. Diagnosis can be challenging, and lack of a timely diagnosis may impact survival. AIM: The aim of this review was to synthesize current knowledge on the diagnosis and surgical management of SP in dogs and cats. CONCLUSIONS: Recent studies suggest refinements of previously reported clinicopathologic criteria improve diagnostic and prognostic accuracy. When evaluating blood-effusion glucose differences, clinicians should be aware of the confounding effects of point of care glucometers. Cytology specimens should be prepared immediately to avoid sample degradation. Advances in imaging have improved the relevance and diagnostic value of ultrasound and computed tomography. Surgical source control that targets the underlying cause is crucial. Accurate assessment of tissue viability may be aided by technologies under development. Anastomotic dehiscence may be reduced by using stapling devices and reinforcement with endogenous or exogenous materials. Evidence for the effectiveness of postoperative drainage via open abdomen ± vacuum-assisted closure, or closed suction drains, is unclear. Heterogeneity of patient severity and incomplete data limit direct comparisons between studies and highlight opportunities for future investigation. IMPLICATIONS: Developments in diagnostic and surgical techniques may improve prognostication and outcomes in septic patients. There are many opportunities for further research into diagnosis and surgical treatment of patients with septic peritonitis.