Peritonitis

Question 1

What is peritonitis?

Answer 1

An acute or chronic inflammation of the peritoneum, typically caused by bacterial or fungal infection.

Question 2

What are the most common causes of peritonitis?

Answer 2

• Bacterial or fungal infection
• Abdominal trauma or surgery
• Pancreatitis
• Cirrhosis with ascites
• Pelvic inflammatory disease

Question 3

Which organisms are most commonly associated with peritonitis?

Answer 3

• E. coli
• Candida species

Question 4

How does a bacterial infection typically enter the peritoneum?

Answer 4

Via perforation in the GI tract.

Question 5

What is spontaneous bacterial peritonitis?

Answer 5

Also known as primary peritonitis; occurs without an identifiable source of infection in the abdomen.

Question 6

What conditions are associated with primary peritonitis?

Answer 6

• Ascites
• Cirrhosis
• Nephrotic syndrome

Question 7

What is secondary peritonitis?

Answer 7

Results from contamination from an intra-abdominal source.

Question 8

What are common causes of secondary peritonitis?

Answer 8

• Perforation
• Postoperative complications
• Trauma
• Ischaemia

Question 9

What is tertiary peritonitis?

Answer 9

Persistent or recurrent infection after adequate treatment for primary or secondary peritonitis.

Question 10

Who is often affected by tertiary peritonitis?

Answer 10

Immunocompromised patients or patients in ICU.

Question 11

What are the stereotypical clinical features of peritonitis?

Answer 11

• Acute abdominal pain (diffuse and severe)
• Nausea
• Vomiting
• Anorexia

Question 12

What are some examination findings in peritonitis?

Answer 12

• Abdominal distension
• Peritoneal signs (rebound tenderness, guarding, rigidity)
• Decreased bowel sounds

Question 13

What is the threshold neutrophil count in ascitic fluid analysis indicating spontaneous bacterial peritonitis?

Answer 13

Neutrophils >250.

Question 14

What imaging findings are associated with peritonitis?

Answer 14

• Free fluid in cavity
• Free air under diaphragm

Question 15

What are the initial steps in the management of peritonitis?

Answer 15

• Initial assessment & resuscitation
• Antibiotic therapy (broad-spectrum)
• Surgical intervention (if indicated)

Question 16

What are potential complications of peritonitis?

Answer 16

• Septic shock
• Abscess formation
• Intra-abdominal adhesions
• Hepatic encephalopathy
• Acute respiratory distress syndrome
• Acute kidney injury
• Prolonged ileus