Peritonitis Flashcards
what is peritonitis
inflammation of the peritoneum (lining of the abdominal cavity). it can be localised or generalised
causes of localised peritonitis
appendicitis, cholecystitis, diverticulitis, salpingitis
causes of primary generalised peritonitis
bacterial infection of the peritoneum without an obvious source- could be from the reproductive tracts
risk factor for primary generalised peritonitis
ascites and nephrotic syndrome
causes of secondary generalised peritonitis
bacterial translocation from a localised focus. could be due to spillage of bowel contents, bile and blood (could be due to perforations)
in what patients is secondary generalised peritonitis common in
surgical patients
presenting symptoms
acute abdominal pain,
continous, sharp and localised pain which is exacerbated by coughing and movement
signs on physical examination of localised peritonitis
rebound tenderness, guarding and rigidity
in peritonitis, what exacerbates the abdominal pain
movement
coughing
signs on physical examination of generalised peritonitis
generally unwell patient, fever, vomiting, tachycardia, hypotension, shallow breathing, generalised abdominal tenderness, reduced bowel sounds
what is a reason for absent bowel sounds
paralytic ileus
what investigations will be done
Bloods- FBC, CRP, ESR, LFTs, U&Es, amylase, clotting screen
imaging- CXR (erect), AXR, CT
why will an erect CXR be done
in case of a pneumoperitoneum in the case of a perforation
what to do if theres ascites
ascitic tap and do cell count
management for localised peritonitis
depends on cause, may require surgery such as appendisectomy, or can be treated with antibiotics (salpingitis)
