Medication
Antibiotic therapy is initiated early in the treatment of peritonitis. Surgical objectives include removing the infected material and correcting the cause. Excision. Surgical treatment is directed towards excision, especially if the appendix is involved. Resection. Resection of the intestines may be done with or without anastomosis.
Procedures
Definition, pathogenesis, and epidemiology Peritonitis is defined as inflammation of the peritoneum, which may be caused by pathogens or non-pathogenic factors, e.g., barium enema. Peritonitis is often synonymously used for intra-abdominal infection or intra-abdominal sepsis in the literature.
Nutrition
Assessing and diagnosing peritonitis involves the following: Increased WBC. Serum electrolyte studies. Abdominal xray. Abdominal ultrasound. CT scan. MRI.
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Definition, pathogenesis, and epidemiology. The incidence of secondary peritonitis is difficult to assess. Intra-abdominal infections are found to occur in 25% of patients with multiple organ failure in surgical ICU. Peritonitis was present in 8% of all cases in a large necropsy series.
What are the surgical objectives of treatment of peritonitis?
What is peritonitis?
How is peritonitis assessed and diagnosed in the workup of peritonitis?
What is the incidence of secondary peritonitis in the US?
What is surgery needed for peritonitis?
Surgery. Surgery is often needed to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading, especially if peritonitis is due to a ruptured appendix, stomach or colon.
Is peritonitis a surgical emergency?
Peritonitis is a common surgical emergency.
Why is laparotomy done in peritonitis?
Peritonitis is quite common cause of surgical emergency and surgical intervention. The increased acceptance of laparoscopy due to its proven benefits of less pain, short hospitalization and decreased morbidity1-4 has encouraged surgeons to use it where it was previously considered as relatively contraindicated.
What causes peritonitis after surgery?
Post-operative peritonitis (PP) is a life-threatening hospital-acquired intra-abdominal infection with high rates of mortality. The most common cause of PP is anastomotic leakage. It is most frequent after rectal resection but it may complicate all gastrointestinal anastomosis.
How can peritonitis be prevented?
Preventing Peritonitis Thoroughly wash your hands, including the areas between your fingers and under your fingernails, before touching the catheter. Wear a mouth/nose mask during exchanges. Observe the proper sterile exchange technique. Apply an antibiotic cream to the catheter exit site every day.
What is the most common complication of peritonitis?
Aggressive fluid resuscitation and early surgical intervention are the mainstay of therapy of peritonitis. Enterocutaneous fistulas, surgical site infection, sepsis, and multiorgan failure are the commonest complications seen in surgical settings.
What is laparotomy operation?
A laparotomy is a surgical incision (cut) into the abdominal cavity. This operation is performed to examine the abdominal organs and aid diagnosis of any problems, including abdominal pain. In many cases, the problem – once identified – can be fixed during the laparotomy. In other cases, a second operation is required.
What is exploratory laparotomy surgery?
Exploratory laparotomy is an abdominal surgery that doctors sometimes use to diagnose abdominal issues. It is usually recommended when other testing did not diagnose or fully resolve an issue. Reasons to perform this surgery include: Abdominal trauma (for example, from an accident)
What are three causes of peritonitis?
What causes peritonitis?A hole in your stomach, intestine, gallbladder, uterus, or bladder.An infection during treatment for end-stage kidney (renal) disease (peritoneal dialysis)An infection of fluid in the belly from end-stage liver disease (cirrhosis)Pelvic inflammatory disease in women.More items...
What is the treatment for secondary peritonitis?
In secondary peritonitis, systemic antibiotic therapy is the second mainstay of treatment following source control (eg, removal of appendix, closure of perforation, resection of gangrenous bowel, drainage of abscess).
How long after surgery can peritonitis occur?
The most common cause of postoperative peritonitis is anastomotic leak, with symptoms generally appearing around postoperative days 5-7.
How long does it take to recover from peritonitis surgery?
This might take 10 to 14 days. Treatment usually involves being given antibiotics into a vein (intravenously). If you have peritonitis caused by kidney dialysis treatment, antibiotics may be injected directly into your stomach lining.
When was peritonitis surgically treated?
Reports on surgical treatment of peritonitis were available at the beginning of the century (Mikulicz 1889; Krönlein 1885; Körte 1892). Kirschner was among the first who demonstrated a reduction in mortality rate by surgical treatment from 80–100% to about 60% in 1926. However, there were doubts that the drainage of the peritoneal cavity is “physical and physiological impossible” (Yates 1905). Since 1926, mortality in peritonitis has decreased to an average of 30–40% with the development of new operative techniques, the introduction of antibiotics and intensive care treatment.
How long should antibiotics be given for peritonitis?
Antibiotics are routinely given for 5–7 days for generalized peritonitis. Antimicrobial agents should be continued until temperature and white blood cell count are within normal limits. Duration of antimicrobial therapy in postoperative peritonitis should not be longer than 7 days. Persistent clinical signs of fever or leukocytosis should prompt a search for a drainable focus of infection in the abdomen or treatable site elsewhere. (Grade A, B and C)
What is secondary bacterial peritonitis?
Secondarybacterial peritonitis describes peritoneal infections secondary to intraabdominal lesions, such as perforation of the hollow viscus, bowel necrosis, nonbacterial peritonitis, or penetrating infectious processes.
What are the signs of peritonitis?
The diagnosis of peritonitis is supported by clinical signs, e.g., abdominal pain and tenderness, nausea, vomiting, diminished intestine sounds, fever, shock, and diagnostic tests, e.g., abdominal x-ray, chest x-ray, ultrasound and CT scan. Ultrasound may be positive in up to 72%, CT in up to 82%. Leukocytes and C reactive protein may be altered but are not direct signs of peritonitis.
What is the difference between sepsis and peritonitis?
Contamination means the presence of bacteria in normal sterile tissue without any host reaction. Infection is the presence of bacteria in normal sterile tissue with local host response (inflammation), clinically evident. Sepsis is the systemic response to local infection. Peritonitis may be caused by traumatic perforation of the bowel, anastomotic dehiscence, translocation of germs, inflammation or perforation of hollow viscus, e.g., appendicitis or colonic diverticulitis.
What is tertiaryperitonitis?
Tertiaryperitonitis, a less well-defined entity, is characterized by persistent or recurrent infections with organisms of low intrinsic virulence or with predisposition for the immunocompromised patient . It usually follows operative attempts to treat secondary peritonitis and is almost exclusively associated with a systemic inflammatory response.
What is the classification of peritonitis?
Peritonitis can be classified into primary, secondary or tertiary peritonitis.
What is the best treatment for peritonitis?
Oxygen therapy. Oxygen therapy by nasal cannula or mask generally promotes adequate oxygenation. Antibiotic therapy. Antibiotic therapy is initiated early in the treatment of peritonitis.
What is Peritonitis?
Appendicitis and diverticulitis may both lead to peritonitis, and all of them are acute inflammatory intestinal disorders.
What causes peritonitis in the kidneys?
Inflammation. An inflammation that extends from an organ outside the peritoneal area such as the kidne ys could cause peritonitis. Bacteria. The most common bacteria implicated are Escherichia coli, Klebsiella, Proteus, Pseudomonas, and Streptococcus.
What is the pathophysiology of peritonitis?
The pathophysiology of peritonitis involves: Leakage. Peritonitis is caused by leakage of contents from abdominal organs into the abdominal cavity. Proliferation. Bacterial proliferation occurs. Edema. Edema of the tissues occurs, and exudation of fluid develops in a short time. Invasion.
Where is peritonitis located?
A: The site for peritonitis is in the peritoneum, the serous membrane lining the abdominal cavity and covering the viscera.
What is the major cause of death from peritonitis?
Sepsis. Sepsis is the major cause of death from peritonitis. Shock. Shock may result from septicemia or hypovolemia. Intestinal obstruction. The inflammatory process may cause intestinal obstruction, primarily from the development of bowel adhesions.
What happens when your abdomen is distended?
Tenderness. The affected area of the abdomen becomes extremely tender and distended, the muscles become rigid, and movement could aggravate it further.