ABSTRACT

This chapter discusses some guidelines for the use of explorative laparotomy in the resolution of the problem of unexplained fever. The implications of fever in surgical practice are quite different from that in nonsurgical patients. Malignant hyperthermia is characterized by fever, frequently associated with rigidity following administration of either a muscle relaxant or potent inhalational agent. Traditional surgical teaching has always dictated that meticulous operative technique will reduce postoperative septic febrile complications. The presence of fever supports the diagnosis of peritonitis but does not help to clarify the etiology of the peritonitis. Anorectal infections may present predominantly as a fever of unknown origin. Total Parenteral Nutrition (TPN) is used to support patients who have multisystem disease, including fever prior to the initiation of TPN. Fever is so common in trauma patients that it is virtually accepted as the norm.