Peritonitis
Peritonitis is an acute inflammation of the peritoneum, the membrane lining the abdominal cavity. It is most commonly triggered by bacterial infections, which may arise from the rupture of abdominal organs, such as the appendix or from conditions like gastric ulcers. Other causes include postsurgical complications, catheter contamination, and infections associated with pelvic inflammatory disease or ascites in patients with chronic liver or kidney failure. Symptoms can vary widely, ranging from severe abdominal pain and fever to diarrhea and shock, making it crucial to seek immediate medical attention for significant abdominal discomfort.
Diagnosis typically involves analyzing fluid from the abdominal cavity through procedures like paracentesis, along with imaging techniques such as ultrasound and X-rays to detect underlying issues. Treatment often requires a combination of supportive measures, antibiotics, and potentially surgery, especially if there is a ruptured organ. Early intervention is vital to preventing serious complications, including sepsis and organ failure, highlighting the emergency nature of peritonitis. Understanding the risks and symptoms can aid in timely diagnosis and treatment, ultimately influencing patient outcomes positively.
Peritonitis
ANATOMY OR SYSTEM AFFECTED: Abdomen, gastrointestinal system, intestines
DEFINITION: An inflammation of the membrane lining the abdominal cavity (peritoneum), usually secondary to a bacterial infection
CAUSES: Bacterial infection, rupture and perforation of organ (e.g., appendix) or gastric ulcer, postsurgical complications, catheter contamination, pelvic inflammatory disease (PID), complication of ascites in chronic liver or kidney failure
SYMPTOMS: May include severe abdominal pain, fever and chills, diarrhea, inability to pass feces and urine, shock, worsening of renal failure, encephalopathy
DURATION: Acute
TREATMENTS: Supportive measures for respiration and circulation, surgery, antibiotics, intravenous fluids
Causes and Symptoms
Peritonitis is an acute condition that typically results from a bacterial infection of the lining the abdominal organs or the abdominal cavity itself, known as the peritoneum. Primary bacterial peritonitis occurs because of a generalized infection, usually with Streptococcus pneumoniae with peritoneal seeding and is usually seen in adolescent girls. Secondary bacterial peritonitis, on the other hand, is caused by the rupture and of a hollow organ of the gut, such as the appendix or a ulcer. Other causes of peritonitis include postsurgical complications, contamination in patients, and infection with enteric from the gut that cause in women. A type called spontaneous bacterial peritonitis is a of ascites seen in chronic liver or kidney failure.
The clinical presentation of peritonitis may vary depending on the severity and source of infection and may range from no symptoms to severe abdominal pain, fever and chills, diarrhea, inability to pass feces and urine, shock, worsening of renal failure, or encephalopathy. Typical bacterial peritonitis may be manifested by an extremely still patient who finds that even slight movement aggravates the pain. Physical examination may reveal tenderness over the abdomen with positive rebound tenderness, in the abdominal cavity, and other signs of liver or kidney failure.
For diagnosis, needle (paracentesis) of the fluid from the abdominal cavity can be done for biochemical and microbiological analyses, including cell count, gram stain, and culture; ultrasound guidance may help in locating the abdominal fluid. Blood cultures may be helpful in some cases. If rupture of a hollow organ is the cause, an x-ray of the shows the presence of air under the diaphragm. Blood cultures are useful in diagnosing spontaneous bacterial peritonitis and primary peritonitis. Ultrasound examination is used to detect fluid in the abdomen.
Treatment and Therapy
The treatment of peritonitis depends on its presentation and cause. Supportive measures to secure adequate and are used for patients who are in critical condition. A ruptured internal organ is usually treated surgically after the patient is stabilized. Infection is managed with antibiotics. Inadequate or improper management of peritonitis may lead to formation, intestinal obstruction, hepatorenal syndrome, encephalopathy, sepsis, and ultimately death.
Peritonitis is an emergency situation, and it is of utmost importance that the condition be diagnosed and treated at an early stage in order to avoid fatal complications. Any case of significant abdominal pain must be examined thoroughly and investigated to rule out peritonitis. The depends directly on the promptness of treatment.
Bibliography
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