What is Abdominal Sepsis?

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  • Written By: Donna Johnson
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 10 November 2019
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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.


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Post 3

@cloudel - Your brother needs to get to the doctor now, because swelling is a big indicator. If he waits until he develops other symptoms, he could require surgery instead of just antibiotics.

My sister had abdominal sepsis because she waited too long to go to the doctor. She ended up with fever and chills, and she also had diarrhea. In the beginning, all she had was a super tender, swollen abdomen. Her discomfort increased with time.

The doctor tested her urine and blood. He also had to draw some of her abdominal fluid out with a needle.

She had to have surgery and take antibiotics for fourteen days. If only she had gone in sooner, she could have avoided the trauma and the big hospital bill.

Post 2

My brother has cirrhosis of the liver, and we think he may be developing abdominal ascites. His abdomen has recently begun to swell, and he says it’s very tender. I am afraid he might develop sepsis if he doesn’t get it treated.

What does a doctor do to test for ascites and infection? My brother hates being poked and prodded by physicians, but I keep telling him that in his case, it is necessary.

Also, what sort of symptoms could hint at sepsis besides swelling? I really want to convince my brother to get checked out, and if he has any symptoms, I’d like to use those as motivation.

Post 1

My mother-in-law developed abdominal sepsis after she had gastric bypass surgery. She nearly died from it. The doctor went so far as to call in the family.

When my husband saw her, he said that she looked so swollen that she didn’t even resemble her former self. The infection had caused her whole body to bloat.

Her stitches from the initial surgery had come loose, and something had ruptured inside of her body. Infection set in before she realized what had happened.

She did recover, but it took a couple of months. She had to be on strong antibiotics, and they had to cut her open to make sure they got all of the infection out. Today, she still has a weak heart because of it.

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