Peritonitis

Question 1

= ?

Answer 1

inflammation of peritoneum. can be localised or generalised. almost always some

Question 2

sx

Answer 2

sudden onset acute abdo pain exacerbated by any movement (incl coughing)
often starts generalised and then localises
shock and fever
“washbaord rigidity) - diffuse rigidity”
absence of bowel sounds
raised pulse
n+v

Question 3

causes of peritonitis

Answer 3

• infective
• leakage of bodily fluids into peritoneum e.g. blood, bile, urine
• autoimmune disease

Question 4

how is infective peritonitis caused

Answer 4

perforation of GI or reproductive tract (swallow sharp object, ulcer, trauma)
disruption of peritoneum e..g surgery/trauma (bacteria from external environment)
spontaneous bacterial peritonitis - occurs in children and pts with ascites

Question 5

what bacteria if caused by perforated GI tract

Answer 5

gram -ve and anaerobics

Question 6

ix

Answer 6

erect CXR - pneumoperitoneum, seen under diaphragm
serum amylase to rule out pancreatitis
US/CT - confirm Dx

Question 7

rx peritonitis

Answer 7

iv fluids
abx if infective
SURGERY to repair perforation and wash out cavity (i.e. sort underlying problem as well as treat peritonitis)

NB SBP only needs abx