The sepsis is a bacterial invasion of the organism producing many manifestations which are able to amplify themselves In the United States of America there are 100.000 death for year and the incidence is among 300.000-500.000 cases. The major surgery in the elder (expecially if it is in emer gency) has a great percental of risk because the preoperati ve study isn’t often complete. Fever, agitation, panting, bullation, abdominal splinting, enteroplegia, are signals of evolving inflammatory situation. Moreover there are disorders of biochemical values: leukocy tosis, thrombocytopenia, increased levels of VES, PCR, amy lase and biliribinaemia. The more common radio logical examinations are the strai ght radi ography of abdomen and torax, abdomen utraso nography, TAC or RMN. In the last years Procalcitonina, 6 Interleukin, C Protein Reactive, nitric oxide by endotelial and muscularis cells has been evaluated as prognostic factors in the septic shock.