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.