Acute Peritonitis Causes Symptoms Diagnosis Treatment

Acute Peritonitis Causes Symptoms Diagnosis Treatment

Peritonitis

Peritonitis is inflammation of peritoneum. Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intraabdominal surgically-treatable source

ACUTE PERITONITIS

  • Peritonitis is inflammation of peritoneum.
  • May be localized or diffuse, acute or chronic, infec­tious or aseptic.
  • Acute peritonitis is usually infectious and related with perforation.
  • There is decreased motility of intestines, with gas and fluid in lumen.
  • There is intravascular volume depletion.

Peritonitis

Acute Peritonitis Causes Symptoms Diagnosis Treatment


Causes of peritonitis are

  • · Perforation of viscus
  • · Foreign body
  • · Peritoneal dialysis
  • · Hernia
  • · Gangrene
  • · Volvulus
  • · Bowel infarction
  • · Cancer
  • · Intestinal obstruction
  • · Inflammatory bowel disease.

Clinical features Symptoms

  • · Acute abdominal pain
  • · Fever
  • · Tenderness
  • · Rigidity
  • · Absent bowel sounds
  • · Tachycardia
  • · Hypotension
  • · Dehydration
  • · Acidosis
  • · Leucocytosis
  • · Edema of bowel wall
  • Ascites prevents the development of a rigid abdomen by separating the visceral from the parietal peritoneal surfaces
  • · Ascites
  • · Free air under diaphragm seen with X-ray, CT, USG (Ultra sonography).
  • The signs and symptoms of both SBP and surgical peritonitis in the presence of ascites can be surprisingly subtle
Risk factors —
  • The vast majority of patients with SBP have advanced cirrhosis
  • . Other risk factors (most of which are associated with cirrhosis) include
  • Ascitic fluid total protein concentration less than 1 g/dL (<10 g/L)
  • Prior episode of SBP Serum total bilirubin concentration above 2.5 mg/dL
  • Variceal hemorrhage Possibly malnutrition
  • Possibly use of proton pump inhibitors

Acute Peritonitis Diagnosis –

  • diagnosis is established by a positive ascitic fluid bacterial culture and an elevated ascitic fluid absolute polymorphonuclear leukocyte (PMN) count (≥ 250 cells/mm3)
  • The prevalence of bacterial overgrowth was higher in the patients with a history of SBP (70 versus 20 percent); these patients also exhibited more severe small intestinal motility disturbances.
  • bacterial translocation is increased in patients with advanced cirrhosis
  • Total protein concentration >1 g/dL (10 g/L)
  • Glucose concentration <50 mg/dL (2.8 mmol/L)
  • Lactate dehydrogenase greater than the upper limit of normal for serum

Acute Peritonitis Treatment

  • Correct hydration, electrolytes Surgical correction
  • Antibiotics
  • Management of complications.
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