Peptic ulcer perforation
ICD-10 K27.1 · ICD-11 DA61/ME24.3Z1

Treatment of Perforated Peptic Ulcer with Community-Acquired Intra-Abdominal Infection and Normal Renal Function

Clinical Scenario

This protocol applies to patients presenting with perforated peptic ulcer as the source of community-acquired intra-abdominal infection, where the patient is not critically ill and renal function is within normal limits.

Key Patient Characteristics

The infection is community-acquired rather than hospital-acquired or healthcare-associated. The patient is hemodynamically stable and not critically ill. Normal renal function is confirmed at presentation. Each of these factors influences empiric treatment selection and the appropriate antimicrobial approach for this specific scenario.

Treatment Approach (Overview)

An empiric broad-spectrum antibiotic regimen directed against gram-negative, gram-positive, and anaerobic bacteria is initiated as early as possible — ideally after peritoneal fluid sampling. The specific agents, combinations, and considerations for patient subgroups (including allergy history and local resistance patterns) are detailed in the full structured protocol.

Treatment Goals

The primary clinical target is normalization of inflammatory markers, expected with a short course of therapy.

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References