The value of surgical treatment in abdominal emergencies : fulminant clostridium difficile colitis and severe abdominal trauma

Abstract

This thesis is a combination of traumatic and non-traumatic events in the abdomen, and the optimization of treatment in both entities. The first part describes the very prevalent infection caused by the bacterium Clostridium difficile. The colitis caused by this infection can be severe and complicated, resulting in high morbidity and mortality. The studies show that by early diagnosis, improved logistics and conservative antibiotic management, treatment can be optimized. In the second part of the thesis, severe trauma to the abdomen is described. In severe renal and liver injuries, as well as in injuries to the pancreatoduodenal complex we show that a more conservative approach is possible, instead of an invasive, surgical treatment. If the clinical situation permits it, even the most severe injuries to the abdomen can be managed without an operation. Additionally we conclude that improved logistics around this specific patient population will be necessary in further optimizing outcomes.