Details Descriptions About :: Peritonitis

 Peritonitis is an acute or chronic inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the visceral organs. Inflammation may extend throughout the peritoneum or be localized as an abscess. Peritonitis commonly decreases intestinal motility and causes intestinal distention with gas. With antibiotics, mortality is now 10%, and it’s usually due to bowel obstruction.

Causes for Peritonitis

Causes Chronic liver disease Renal failure Appendicitis, diverticulitis Chronic liver disease Renal failure Peptic ulcer, ulcerative colitis Volvulus, strangulated obstruction Abdominal neoplasm Penetrating trauma, such as a stab wound Rupture of a fallopian tube or the bladder Perforation of a gastric ulcer Released pancreatic enzymes

Pathophysiology Peritonitis

Pathophysiology Although the GI tract normally contains bacteria, the peritoneum is sterile. When bacteria or chemical irritants invade the peritoneum due to inflammation and perforation of the GI tract, peritonitis is the result. Accumulated fluids containing protein and electrolytes make the transparent peritoneum opaque, red, inflamed, and edematous. Because the peritoneal cavity is so resistant to contamination, infection is commonly localized as an abscess.

Signs and symptoms Peritonitis

Signs and symptoms Sudden, severe, and diffuse abdominal pain that tends to intensify and localize in the area of the underlying disorder, such as right lower quadrant in appendicitis Acutely tender, distended, rigid abdomen; rebound tenderness Pallor, excessive sweating, cold skin Absent or diminished bowel sounds Nausea, vomiting, abdominal rigidity Signs and symptoms of dehydration (oliguria, thirst, dry swollen tongue, and pinched skin) Temperature of 103 F (39.4 C) or higher Shoulder pain Hypotension Tachycardia Cloudy peritoneal dialysis fluid Clinical Tip Abdominal distention and resulting upward displacement of the diaphragm may decrease respiratory capacity. Typically, the patient with peritonitis tends to breathe shallowly and move as little as possible to minimize pain. He may lie on his back, with knees flexed, to relax abdominal muscles.

Diagnostic Lab Test results

Diagnostic test results Abdominal X-ray shows edematous and gaseous distention of the small and large bowel or in the case of visceral organ perforation, air lying under the diaphragm. Chest X-ray shows elevation of the diaphragm. Blood studies show leukocytosis. Paracentesis reveals bacteria, exudate, blood, pus, or urine. Laparotomy identifies the underlying cause.

Treatment for Peritonitis

Treatment Emergency treatment Nothing by mouth—to slow peristalsis and prevent perforation Nasogastric intubation Antibiotics, based on infecting organism Analgesics Parenteral fluids and electrolytes When peritonitis results from perforation, surgery should be performed as soon as possible to eliminate the source of infection by evacuating the spilled contents and inserting drains.

 

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