Peritonitis

Question 1

What is peritonitis?

Answer 1

inflammation of the peritoneal lining

Question 2

What is the possible pathophysiology behind peritonitis?

Answer 2

• inflammation
• vasodilation
• hypovolemia
• SIRS/DIC/MODS

Question 3

Which factors can worsen the severity of peritonitis?

Answer 3

• high level of bacteria
• virulence of organisms
• presence of adjuvants
• inadequacy of immune response

Question 4

What is the cause and prevalence of primary septic peritonitis?

Answer 4

• hematogenous or lymphatic spread of bacteria

- very rare

Question 5

What is the most common cause of primary aseptic peritonitis?

Answer 5

feline infectious peritonitis

Question 6

What are the possible causes of secondary aseptic peritonitis?

Answer 6

• chemical peritonitis
• peritoneal foreign body
• mechanical peritonitis

Question 7

What is the most common form of peritonitis?

Answer 7

secondary septic peritonitis

Question 8

What is the possible pathophysiology of secondary septic peritonitis?

Answer 8

• infection from the GIT
• E. coli, Bacteriodes
• abscess of liver, pancreas, omentum, etc.
• abdominal trauma

Question 9

What are the clinical signs associated with secondary aseptic peritonitis?

Answer 9

• early signs: vomiting, lethargy, abdominal pain

- more severe with worsening condition

Question 10

Which tests should be done diagnose peritonitis?

Answer 10

• MDB
• blood gas
• coagulation profile
• radiograph/ultrasound
• abdominocentesis

Question 11

What diagnostic results are suggestive of septic peritonitis?

Answer 11

• pneumoperitoneum

- abdominal effusion (BG and lactate)

Question 12

How is peritonitis treated?

Answer 12

• stabilize the patient first
• exploratory celiotomy
• fluid therapy
• antibiotics
• analgesia

Question 13

What are the goals when performing surgery to correct peritonitis?

Answer 13

• repair/remove bacterial source
• debride necrotic tissues
• remove foreign material and nflammatory mediators (lavage)

Question 14

When is a primary closure of peritonitis surgery indicated?

Answer 14

• if underlying cause is corrected

- contamination can be removed

Question 15

What are the indications for open peritoneal drainage?

Answer 15

• severe generalized peritonitis
• ongoing contamination
• extensive fibrinous adhesions

Question 16

What is the prognosis for peritonitis?

Answer 16

• better prognosis with early antibiotic tx

- guarded to poor (50%)