Compared to uncomplicated intra-abdominal infection (IAI), complicated IAI extend beyond the source organ and into the peritoneal cavity through the perforated bowel. Most of intra-abdominal infection encountered in the surgical field is secondary or tertiary peritonitis. In this article authors report management experiences of unusual two cases about complicated IAI; the first case is abdominal wall abscess accompanied by perforation of ascending colon perforation from traumatic mesentery injury, and the second case is about liver abscess followed by pleural empyema. In the first case, abdominal wall abscess was drained by ultrasonography-guided incision and drainage, and negative pressure wound therapy (NPWT) was applied on the soft tissue defect site. In the second case, right pleural empyema was formed after percutaneous liver abscess drainage, and thoracoscopy-assisted pleural decortications and drainage of pleural effusion were performed. For the treatment of complicated IAI, source control is the most important and proper empirical antibiotic and susceptible therapeutic antibiotics are also needed. (J Surg Crit Care 2012;2:71-74)
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