The Challenge of Postoperative Peritonitis Due to Anastomotic Leakage

Anastomotic leakage is a common cause for postoperative peritonitis and associated with high mortality and morbidity. Management of secondary peritonitis remains challenging and requires a multidisciplinary approach, adequate ICU support and 24/7 decision-making. Contrast-enhanced CT imaging is required before relaparotomy. Current evidence points towards on-demand strategy as the preferable strategy for ongoing or recurrent peritonitis with primary abdominal closure following emergency surgery. Temporary closure techniques using mesh-mediated negative pressure treatment devices can be used to promote abdominal closure and prevent fistulas.