Which one is more common in vet med: primary or secondary generalized peritonitis?
Secondary
Primary generalized peritonitis
Spontaneous inflammation without any obvious intraabdominal leakage of bacteria.
Secondary generalized peritonitis
Occurs in conjunction with intraabdominal reason for inflammation/infection (can be infectious or non-infectious)
Non-infectious secondary peritonitis
- Chemical
- Gastric fluid
- Pancreatic fluid
- Bile: rupture, if infected becomes infectious peritonities
- Urine:
- Healthy - sterile - non-infectious
- Infected urine - becomes infectious peritonitis
- Glove powder (starch peritonitis)
- Mechanicam (intraperitoneal foreign body)
Infectious periotnitis: causes
- Leakage of GI contents (including ruptured GI neoplasms)
- Ruptured pyometra, gall bladder, infected urinary bladder
- Penetrating wounds
- Ruptured abscesses
- Iatrogenic
Pathophysiology of peritonitis
- Peritoneal injury
- Increased capillary permeability
- Accumulation of fluid
- Decreased circulating volume
- Decreased cardiac output
- Decreased tissue perfusion
- Hypoxia
- Cellular death
- Organ failure
- Death
Diagnosis - radiographs
- Loss of serosal detail
- Free gas - horizontal beam, diaphragm
- Generalized ileus
- Fluid lines
- Foreign bodies
- Tumors
Diagnosis: ultrasound
- Helps localize free fluid - abdominocentesis
- Very good for looking at organ parenchyma (cysts, abscesses, tumros, intussusceptions)
- May help determine the etiology (pancreatic abscess)
Lab findings help you know what you need to change to stabilize your paitnet ____ going to surgery.
BEFORE
Abdominocentesis is a ___ quadrant tap.
four
Upon cytology of fluid, in periotnitis, shoudl see…
degenerative neutrophils and intracellular bacteria
Septic peritonitis - supprotive diagnostics: glucose
Abdominal fluid glucose <50mg/dL
Difference between abdominal glucose and blood glucose >20 mg/dL
Septic peritonitis - supportive diagnostics - lactate
- difference between blood and fluid
- Dogs: < 2.0 mmol/L
- Cats: not as reliable
When you MUST recommend surgery:
- Free air in the abdomen (you can have small amounts of air post-op for up to 3 weeks
- Peritoneal intracellular bacteria
- Glucose or lactate levels supprot diagnosis
- Penetrating wound over abdomen
- Traumatic abdominal hernia
For treatment pre-op, do NOT use ____
Corticosteroids and/or NSAIDs
How much lavage to use?
200-300 mls of lavage per kg minimum (1 L per 10 lbs)
In severe cases, consider treating the case as an “____”
Open abdomen
Mortality rate is –
20-70%
-
Wound Closure Biomaterials45
-
Suture Technique - Knot tying, suture patterns, and hemostasis52
-
Principles of Surgery20
-
Wound Healing25
-
Wound Management33
-
Primary Wound Closure Techniques23
-
Skin Flaps and Grafts30
-
Upper Airway Surgery58
-
Low Respiratory Surgery83
-
Exploratory Celiotomy39
-
Peritonitis18
-
Hernias I65
-
Hernias II23
-
Head and Neck I Note Card Set37
-
Head and Neck II Note Card Set28
-
Urinary Surgery Note Card Set21
-
Oral Tumors Note Card Set25
