A BRIEF NOTE ON PERITONITIS, CAUSES, DIAGNOSIS, MANAGEMENT

peritinitis

2. —

E =

FUNCTION OF PERITONEUM

© Peritoneum is the largest serous membrane of the body.

* Consist two part:

* 1, Parietal layer:Part attaches to cavity wall.

= 2. Visceral layer:Part that covers and attaches to the organ
inside this cavity,

+ Each layer consist of areolar connective tissue covered by
mesothelium(simple squamous epithelium)

* Mesothelium secretes serous fluid(watery lubricating fluid
that allowed organ to glide easily over one and other or to
slide again the wall of cavities),

3. DEFINITION

+ Peritonitis is an inflammation (irritation) of the
peritoneum, the thin tissue that lines the inner wall of
the abdomen and covers most of the abdominal

organs.

4. Peritonitis is an inflamation of the
peritoneum, the serous memberan that

lines part of the abdominal cavity.
Peritonitis may be localized or
generalized, and may result from
infection and from a non-infectious

process.

5. 1-Infected peritonitis (localized or
generalized infected peritonitis) or
© none infected peritonitis

2 Primary or secondary peritonitis

7. Etiology (secondary peritonitis )

« Perforation of a viscus into the
peritoneal cavity
* Trauma

« Infected intraperitoneal blood from any
source (eg, trauma, surgery, ectopic pregnancy)
can become infected and lead to peritonitis.

' Foreign bodies
* Pancreatitis

8. Etiology (secondary peritonitis )

Peritoneo-systemic shunts, in common with other long-lasting
poñtoneal drains, tond to become infected and load to poritonalis,

Drains of any type may furnish an entry for bacteria into the
pentoneal cavity.

Barium introduced into the peritoneal cavity via an enema through a
perforated diverticulum can lead to acute and later to chronic
peritonitis because of the combination of barium and infection.

Meconium peritonitis can occur from perforation of the bowel in
utero.

Porttoneal dialysis

9. peritoneum, e

f perforation of a hol

micro-organism into the
peritoneal cavity. Examples include
trauma, surgical wound, continuous
ambulatory peritoneal dialysis, and
intra-peritoneal chemotherapy.

10. “3Í Direct entry through an operative or
* traumatic wound.

4. Intra-peritoneal dialysis predisposes

to peritoneal infection

5. Though blood spread in cases of
septicemia and pyaemia but is rare.

2) Sy 5 A A

11. PATHOPHYSIOLOGY

Lealtage:- peritonitis is caused by leakage of contents from abdominal
cavity

Proliferation : Bacterial proliferation occur
Edema :- occurs and exudation of (iid develops in a short time

Invasion : Fluid in the peritoneal cavity becomes turbid with increasing
amounts of protein, WHC, cellular debris and bhood,

Response :- the immediate response of the intestinal tract is
hypermotallty. Soon followed by paralytic ilus with an accumilation of
air and fluid in the bowel,

12. Peritonitis

7
Peritonitis is inflammation of the peritoneum, which is the inner lining
of the abdominal wall that covers the organs found in the abdomen.
This is usually duetoa fungal or bacterial infection

Common Causes Signs and Symptoms
S =

+ Burst stomach ulcer AC = + Abdominalpain
+ Burstappendix + Abdominal distension

. Diverticulitis . Fever

Pancreatitis + Nausea or Vomiting
Surgery . Diarrhoea
. Trauma « » Reduced urine output

. Cirrhosis | . Fatigue
TN ‘in . Confusion

13. —_

— MA

SIGN AND SYMPTOM

* Abdomen painful

+ Abdominal distention.

+ Fever and chills

* Passing few or no stools or gas
* Excessive fatigue

* Passing less urine

+ Nausea and vomiting

14. ina tonaac

SYMPTOMS OF

PERITONITIS

Peritonitis is a life-threatening condition

Peritonitis is an inflammation of the membrane that lines the abdominal wall and organs.
It is caused by leakage in the intestines.

es) Extreme thirst ap) Vomiting
Fatigue
Ss Bloating

ame constat
S

Diarrhea
le») Low urine output
Nausea
a Inability to pass gas

15. DIAGNOSTIC TEST

2 Physical exam.

© Peritoneal fluid analysis.(Using a thin needle, doctor
may take a sample of the fluid in peritoneum
(paracentesis)

+ Blood tests.(TWBC)

+ Imaging tests (Abdominal X-ray)

16. Treatment of peritonitis

Primarily involves treatment of the underlying disease,

General therapy includes antibiotics, nasogastric intubation and suction,
respiratory care, and fluid and electrolyte replacement.

The most effective antibiotic regimen to give before results of cultures are
available is debatable.

Third-generation cephulosporins are effective and probably safest. A
combination of gentamicin and clindamycin is effective but dangerous if’
renal function is diminished,

17. —

TREATMENT

* Antibiotics are usually administered intravenously,
but they may also be infused directly into the
peritoneum.Example:Ampicillin.

> Surgery(laparotomy) is to correct any gross
anatomical damage that may have caused peritonitis

18. ~ General supportive measures such as
intravenous rehydration and correction of
electrolyte disturbances.

2. Antibiotics are usually administered

intravenously, but they may also be infused
directly into the peritoneum.

19. c roars +
Surgical tr

-laparotomy is needed to perform a

full exploration and lavage of the
peritoneum.