A nurse is caring for a young patient who is recovering from a laparoscopic appendectomy following acute appendicitis. 18 hours post-procedure the patient develops a high fever, severe abdominal pain, and nausea. The abdomen is rigid with rebound tenderness and guarding. She is hemodynamically stable. The nurse suspects which complication?

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Intraabdominal abscess. Signs and symptoms of acute peritonitis (rigid abdomen, rebound, fever, severe abdominal pain) immediately following an appendectomy are almost always secondary to intra-abdominal contamination during the procedure resulting in the formation of an intra-abdominal abscess. Surgical site infections usually present less acutely and are milder. Post-surgical bleeding into the abdomen would give peritoneal signs but the patient would be less likely to spike a high fever and would likely present with hypotension. Pulmonary embolism would present as dyspnea and chest pain, rather than abdominal pain.

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