Peritonitis

Question 1

Give 3 symptoms of peritonitis.

Answer 1

1. Pain.
2. Tenderness.
3. Systemic symptoms e.g. nausea, chills, rigor.

Question 2

What investigations might you do in someone who you suspect could have peritonitis?

Answer 2

1. Blood tests: raised WCC, platelets, CRP, amylase. Reduced blood count.
2. CXR: look for air under the diaphragm.
3. Abdominal x-ray: look for bowel obstruction.
4. CT: can show inflammation, ischaemia or cancer.
5. ECG: epigastric pain could be related to the heart.
6. B-HCG: a hormone secreted by pregnant ladies.

Question 3

Give 5 potential complications of peritonitis.

Answer 3

1. Hypovolaemia.
2. Kidney failure.
3. Systemic sepsis.
4. Paralytic ileus.
5. Pulmonary atelectasis (lung collapse).
6. Portal pyaemia (pus in the portal vein).

Question 4

Explain how paralytic ileus can lead to respiratory problems.

Answer 4

Peristaltic waves stop -> dilation of bowel -> distended abdomen therefore increased pressure -> pushes on diaphragm -> respiration affected.