PERITONITIS

Done by : Ali Qassim AlSharif

Academic number:208040270

Introduction 

Peritonitis is inflammation of the peritoneum due to a bacterial or fungal infection. The most common symptom of peritonitis is severe abdominal pain.

What is Peritonitis?

Types of peritonitisThere are two main types of peritonitis:

primary spontaneous peritonitis, where an infection develops in the peritoneum, and secondary peritonitis, where an infection or injury in another part of the body leads to bacteria or fungi infecting the peritoneum.

Causes :

Primary peritonitis Infection of the peritoneum can happen for a variety of reasons. Here are

the most common causes of peritonitis:

Peritoneal dialysis:. Dialysis removes waste products and extra fluid from your blood when your kidneys can no longer adequately do so. With peritoneal dialysis, the network of tiny blood vessels in your abdomen (peritoneal cavity) is used to filter your blood. Peritonitis is the most common complication associated with peritoneal dialysis. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment.

Fluid buildup:. Diseases that cause liver damage, such as cirrhosis, can result in a large amount of fluid buildup in your abdominal cavity (ascites). That fluid buildup is susceptible to bacterial infection. This type of peritonitis is called spontaneous peritonitis.

Secondary peritonitis

When other medical conditions result in an infection that causes peritonitis, it's referred to as secondary peritonitis. These causes include:

A ruptured appendix, stomach ulcer or perforated colon

Pancreatitis

Diverticulitis

Trauma

Risk Factors

The following factors may increase the risk for primary peritonitis:

i.Liver disease (cirrhosis) ii.Fluid in the abdomen iii.Weakened immune system iv.Pelvic inflammatory disease

Risk factors for secondary peritonitis include:

i.Appendicitis (inflammation of the appendix) ii.Stomach ulcers iii.Torn or twisted intestine iv.Pancreatitis v.Inflammatory bowel disease, such as Crohn's disease or ulcerative colitis vi.Injury caused by an operation vii.Peritoneal dialysis viii.Trauma

Signs and Symptoms:

The signs and symptoms of peritonitis include:

A.Swelling and tenderness in the abdomen with pain ranging from dull aches to severe, sharp pain B.Fever and chills C.Loss of appetite D.Thirst E.Nausea and vomiting F.Limited urine output G.Inability to pass gas or stool

Complications

Left untreated, peritonitis can extend beyond your peritoneum, where it may cause:

A bloodstream infection (bacteremia).

An infection throughout your body (sepsis). Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure.

Tests and diagnosis

Diagnosing peritonitis involves a number of tests, including:

Physical examination – the abdomen is hard and painful. There are no bowel movements or sounds.

Signs of shock – including low blood pressure, abnormal pulse rate and pale skin.

Blood tests – to check for which bacteria are responsible.

X-rays – of the abdomen. Laparoscopy – a slender tube is inserted through an abdominal incision and the insides examined.

Peritoneal fluid culture – a sample of fluid is taken and examined for signs of infection.

Treatment options

Treatment options for peritonitis depend on the cause, but may include:

Hospitalisation – often in an intensive care unit.

Antibiotics – tailored to the specific bacteria to kill the infection.

Intravenous fluids – to rehydrate the body and replace lost electrolytes.

Surgery – to repair the ruptured organ and wash out the abdominal cavity of blood and pus.

Treatment for the underlying cause – such as a perforated ulcer.

Prevention

Often, peritonitis associated with peritoneal dialysis is caused by germs around the catheter. If you're receiving peritoneal dialysis, take the following steps to prevent peritonitis:

i.Wash your hands, including underneath your fingernails and between your fingers, before touching the catheter

ii.Clean the skin around the catheter with antiseptic every day

iii.Store your supplies in a sanitary area

If you've had spontaneous peritonitis before, or if you have peritoneal fluid buildup due to a medical condition such as cirrhosis, your doctor may prescribe antibiotics to prevent peritonitis.

Things to remember

Peritonitis is the inflammation of abdominal membranes, most commonly due to bacterial infection.

Peritonitis is life threatening if not treated promptly.

Treatment options include hospitalisation, antibiotics and surgery.

Summary

Peritonitis is inflammation of the membranes of the abdominal wall and organs. Peritonitis may be caused by the rupture of infected organs such as the appendix or bowel. Symptoms include strong abdominal (stomach) pain. Peritonitis is life threatening if not treated promptly.

References:

http://www.mayoclinic.com/health/peritonitis/DS00990/DSECTION=preventionhttp://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Peritonitis?open

http://www.nhs.uk/Conditions/Peritonitis/Pages/Treatment.aspx

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002311

http://www.umm.edu/altmed/articles/peritonitis-000127.htm

Websites

References:Books

An Aid to Clinical Surgery: Robin C. N. Williamson MA MD MChir FRCS, Bruce P. Waxman BMedSc MBBS FRACS FRCS(Eng) FACS.

Bailey and Love's Short Practice of Surgery [23rd Edition]Hamilton Bailey(Author), R.J.McNeill Love(Author), R.C.G. Russell (Editor), etc. (Editor), N.S. Williams (Editor), C.J.K. Bulstrode (Editor) Lecture Notes: General SurgeryHarold Ellis (Author), Roy Calne (Author), Christopher Watson (Author)