Peritonitis

Question 1

What is Peritonitis?

What are 2 types? (Can be infectious or sterile)

Answer 1

Inflammation of the serial membrane lining the abdominal cavity (normally sterile)

• Primary/ Spontaneous Bacterial Peritonitis (SBP)
• Secondary (Breakdown of peritoneal membranes leading to foreign substances entering cavity)

Question 2

What are the 2 sections of the Peritoneal Cavity and what connects them?

Answer 2

Greater and Lesser Sacs connected by Foramen of Winslow

Question 3

Primary Peritonitis/ (SBP) involves infection of what?

How is it diagnosed?

Answer 3

Ascitic fluid

(Ascites is pathological collection of fluid within the peritoneal cavity)

Aspirating ascitic fluid, neutrophil count >250/mm^3

Question 4

What causes Ascites in Cirrhosis? (Can lead to SBP/ Primary Peritonitis)

Answer 4

Combination of;

• Portal hypertension causes increased hydrostatic pressure in veins draining gut
• Decreased liver function resulting in less albumin production

Question 5

List 3 symptoms of Primary Peritonitis/ SBP

Answer 5

Commonly mild;

• Ab pain
• Fever
• Vomiting

Question 6

What is Secondary Peritonitis a result of?

Answer 6

• Due to an inflammatory process secondary to

- Inflammation, perforation or gangrene of an intra-abdominal or retroperitoneal structure

Question 7

List 4 common causes of Secondary Peritonitis

Answer 7

• PUD (perforated)
• Appendicitis (perforated)
• Diverticulitis (perforated)
• Post surgery

Question 8

List 2 non-bacterial causes of Secondary Peritonitis

Answer 8

• Ovarian Cyst
• Tubal pregnancy that bleeds into cavity

(Blood is highly irritant)

Question 9

What is the most common symptom of Peritonitis?

Answer 9

Abdominal pain-> Lying very still

Gradual or acute onset

Question 10

How can Peritonitis be treated in 3 ways?

Answer 10

• Control infectious source (Surgery)
• Eliminate bacteria and toxins (Antibiotics)
• Maintain organ system function (Intensive care)