Specific causes of peritonitis

A lecture made based on bailey and love

1. Specific Causes of Peritonitis

2. Lecture 3 May 20, 2018

3. National lead for GlobalSurg Collaborative National Lead with GlobalSurg ® for FALCON trial Co- Prinicipal Investigator for NRPU grant Collaborator for European Coloproctology society, UK Colorectal Fellowship, Yonsei University, South Korea Fellow of College of Physicians & Surgeons, Pakistan (Surgery) Fellow of Higher education authority of UK (FHEA) Member of Royal College of Surgeons, England (UK) Member of College of Physicians & Surgeons, Pakistan (Surgery) Member Editorial Board, BMJ case reports since 2011-2014 Reviewer for Rawalpindi Medical Journal since 2015 Dr. Ahmad Uzair Qureshi

4. Bile Peritonitis

5. Bile Peritonitis

6. Bile Peritonitis

7. Bile Peritonitis

8. Bile Peritonitis

9. Spontaneous Bact. Peritonitis Clinical features

10. Spontaneous Bact. Peritonitis Diagnosis

11. Spontaneous Bact. Peritonitis Diagnosis 250 cells / mm 3

12. Spontaneous Bact. Peritonitis Diagnosis 250 cells / mm 3 Micro-organism

13. Spontaneous Bact. Peritonitis Gram Positive Gram Negative Bacteria

14. Spontaneous Bact. Peritonitis Management

15. Primary pneumococcal peritonitis Nephrotic syndrome or cirrhosis in children Routes : Females/ Males Temp/ Vomiting / Pelvic inflammatory manifestation/ Differential Leukocyte Count: 90% PMN Exudate : Sticky & odourless

16. Familial Mediterranean fever (periodic peritonitis) Mutations in the MEFV (Mediterranean fever) gene Abdominal pain and tenderness, mild pyrexia, polymorphonuclear leukocytosis Role of Surgery

17. Tuberculous Peritonitis Mycobacterium avium - ( HIV) co-infection. The abdomen is involved in 11% of patients with extrapulmonary TB I leocaecal is the most common site of involvement ) Ascitic fluid is typically a straw-coloured exudate Protein >25–30 g/L White cells >500 mm3 Lymphocytes >40%.

18. Tuberculous Peritonitis Acute (may be clinically indistinguishable from acute bacterial peritonitis ) and chronic forms Abdominal pain, sweats, malaise and weight loss are frequent Ascites common, may be loculated Caseating peritoneal nodules are common Intestinal obstruction may respond to anti-tuberculous treatment without surgery