peritonitis

Question 1

what are the differentials for colic and pyrexia?

Answer 1

• peritonitis
• Colitis
• Enteritis - not very common inthe uk, more common in europe
• Non-GI
  ◦ Pleuropneumonia
  ◦ Other infections

Question 2

what would you see in a case of peritonitis on haematology and abdominocentesis?

Answer 2

Haematology
* Leukopaenia
* Haemoconcentration/azotemia/acidosis
* Increased acute phase proteins

Abdominocentesis
* Total Nucleated Cell Count – greater than 5x109cells/L
* Lactate – greater than 2mmol/L
* Glucose – less than 2mmol/L

can do culture and sensitivity on abdo fluid

Question 3

what is the treatment for peritonitis?

Answer 3

• Antimicrobials - Penicillin and gentamicin
• IV fluids
• ± Abdominal lavage/drainage

Question 4

what is the prognosis for peritionitis?

Answer 4

Depends of source of contamination
* Poor with GI rupture
* Following abdominal surgery guarded
* Without rupture generally good