GI Disorders - Peritonitis

Question 1

What is peritonitis?

Answer 1

inflammation of the peritoneum which interferes with normal fxn of internal organs

Question 2

What is the peritoneum?

Answer 2

a serous membrane that lines the peritoneum cavity outside the gut

Question 3

Etiology of peritonitis:

Answer 3

• bacteria (E. Coli. makes contact outside the gut causing infection and inflm)
• bile, gastric acid (HCl and gastric acid leaves GIT thru perforation)
• pelvic inflammatory disorder
• others: physical damage, chemical irritation, or any disease/injury that can perforate in bowel

Question 4

Etiology: Bacteria

What bacteria is found in GIT?

Answer 4

Bacteria is normally E. coli found in the gut flora.

E. coli cause infection when it make contact outside the gut to the peritoneum.

Question 5

Etiology: Bile, gastric acid

What dieases causes this?

Answer 5

Gut content (chemicals and enzymes) in upper GIT enters the body cavity d/t perforation in the bowel.

Diverticular Disease and PUD.

Question 6

Etiology: PID

Answer 6

Bacteria from vagina move thru the reproductive system into the body cavity.

Question 7

Patho of Peritonitis

Answer 7

• An agent (eg bacteria) that impacts peritoneum triggers inflammation –> prod. of purulent exudate.
• peritoneum is a large structure
• thick and sticky exudate
• reduce GI motility (compensatory)

Question 8

Patho: What are the 2 disadvantages of the perineum being large?

Answer 8

1. richly vascularized t/f infection and inflm can spread easily across structure thru blood vessels
2. toxins produced by bacteria are rapidly absorbed

Question 9

Patho: What are 2 benefits of the thick and sticky purulent exudate caused by the inflm?

Answer 9

1. seals the perforation

2. restricts the inflammation by slowing the spread of the agent (localizing inflammation)

Question 10

Patho: Benefit of reducing GI motility? How? What is it referred to as?

Answer 10

Slow the spread of gut content thru perforation in gut.

A compensatory mech. by SNS to restrict GI motility

Ileus = cessation of peristalsis

Question 11

What is an ileus?

Answer 11

lack of normal muscle contraction in the intestines

Question 12

Manifestation of Peritonitis (6)

Answer 12

• very severe
• alternate perfusions (hyperemia): shunt blood from one place to another
• fluid shift: from bowel to abdominal cavity (third spacing and potential for ascites)
• ileus: accum. of bowel content and risk for obstruction
• fever, pain, and vomiting: d/t infection, inflammation, and vomiting is a local mnfst
• dyspnea: breathing causes diaphragm to irritate the inflamed peritoneum d/t close proximity

Question 13

Treatment of Peritonitis (7)

Answer 13

• NPO: food initiate peristalsis and more content move into peritoneum
• IV antibiotics
• NG suction: prevent content moving into the body cavity
• Correct fluids and electrolytes imbalance
• anti-inflammatories
• analgesics
• sx: depend on circumstance eg substantial perforation or obstruction , ulcers, or appendicitis