Peritonitis

Question 1

what is the peritoneum

Answer 1

large extensive membrane in the abdominal cavity

Question 2

what is peritonitis

Answer 2

inflammation of the peritoneum caused by normal flora in the gut entering into the body cavity and causing infection

Question 3

Etiology of peritonitis

Answer 3

• due to bacteria (especially E.coli) or chemical irritation (bile,HCL) perforation can cause chemicals to enter body cavity
• some top reasons for peritonitis:
  - ruptured appendix
  - perforated ulcer or diverticulum
  - PID (pelvic inflammatory disorders)
  - several others

Question 4

what are some of the top reasons for peritonitis?

Answer 4

• ruptured appendix
• perforated ulcer or diverticulum
• PID (pelvic inflammatory disorder)
• several others

Question 5

what is the Patho of peritonitis

Answer 5

• agent impacts peritoneum causing inflm
• peritoneum is large structure (inflm will be extensive) & highly vascularized so: rapid absorption of toxins and spreads easily
• thick, sticky fibrinous exudate develops (has an advantage - plugs perforation): -seals perforation -localizes inflm
• SNS limits GI motility(compensatory)

Question 6

what are the advantages of the sicky fibrinous exudate that develops in peritonitis

Answer 6

• seals perforation (plugs perforation)

- localizes inflm

Question 7

what kind of exudate develops in peritonitis?

Answer 7

thick, sticky, fibrinous exudate

Question 8

why does the sympathetic nervous system limit GI motility with peritonitis?

Answer 8

compensatory mechanism, which will inhibit peristalsis, preventing contents from gut spilling out of perforation

Question 9

Mnfts of peritonitis

Answer 9

• severe (because of size and vasculature)
• fluid shift into bowel & abdm cavity (fluid moves out of blood vessels and into body cavity (3rd spacing))
• perfusion altered: -blood shunted to site of inflm (problem is that may possibly lead to hypovolemic shock)
• pain, vomiting (vomiting is not a local mnfts it is d/t severe pain)
• Dyspnea (pain on breathing as diaphragm movement contracts & relaxes. person will adjust breathing to reduce pain)

Question 10

treatment of peritonitis

Answer 10

NPO: -if continue to ingest food would cause more content to moveout @ site of perforation

• pre surgery need to be NPO
• IV Abx (if due to bacterial infection)
• NG suction
• Fluids & electrolytes
• anti-inflm
• narcotics (for pain)
• Sx if indicated