Acute appendicitis remains one of the most common surgical emergencies, with a lifetime incidence of approximately 7–8% in the USA and Europe. Despite the widespread adoption of the laparoscopic approach and advances made in perioperative care, post-operative infections—particularly intra-abdominal abscesses—continue to pose a substantial clinical challenge, with an overall probability that ranges from 5 to 15%. Nowadays, it is essential not only to improve patient outcomes by reducing these complications but also to promote responsible antibiotic use. This review provides an in-depth examination of post-appendectomy infections in adults, synthesizing research from the past decade. It explores the various risks involved, including those related to the patient, the disease itself, and the surgical techniques employed. There is particular emphasis on the impact of surgical approach, closure methods, timing of surgery, and intraoperative decisions such as drain placement, peritoneal lavage, and routine bacterial cultures. Part of the discussion is about emerging data regarding the use of antiseptic solutions and specimen retrieval techniques. Additionally, the review examines current approaches to managing postoperative intra-abdominal abscesses. It assesses when antibiotics are necessary, evaluates image-guided percutaneous drainage, and considers laparoscopic re-intervention as a possible solution. While recent studies offer valuable insights, the heterogeneity of available evidence highlights the pressing need for high-quality, standardized research. Ultimately, a deeper understanding of infection pathways and preventative strategies is vital—not only for reducing morbidity and hospital readmissions, but also for safeguarding the long-term efficacy of antibiotics and delivering safer, more effective surgical care.

Pancreatic and extrahepatic biliary tree traumas are rare traumas, due to specific trauma dynamics. They may require both non-operative and operative management, according to the severity of injury. In the case of operative management, a multidisciplinary approach is crucial to improve clinical outcomes, to reduce complications and to ensure complete management of injuries. The case presented is an example of such a multidisciplinary approach in polytrauma, in which the combination of surgical and endoscopic approach allowed to manage severe common biliary duct and pancreatic head injury, creating a “neoampulla”. This is the first case described in literature of such an approach in common bile duct traumatic injury.

Intra-abdominal infections are an important cause of morbidity and mortality; for this reason, prevention, early clinical diagnosis, complete source control, adequate antimicrobial therapy, and prompt resuscitation in critically ill patients are of major importance to prevent adverse outcomes. The application of individualized prophylaxis and therapy, based on patient characteristics, disease features and epidemiology of the main selected microorganisms is fundamental to treat intra-abdominal infections, especially in critically ill patients.