Abdo infection Flashcards
2 forms of infected abdomen
- peritonitis
2. abdo abscess
def of peritonitis
infected material in one region or all over peritoneaum
2 sources
1ry source - unimicrobial
2ry source -from amspill
def. abscess
local collection of pus
1 most common and 3 less common sources of infection in gut
common - GI bact. leak uncommon - via portal blood - via biliary ascent - via systemic blood (hematogenous)
how does perionitis spread
fluid flow, resp, gravity
3 classes of abscesses
- intrapertoneal
- retropertoneal
- visceral
4 mechs by which bugs get in
- perf - always
- ischemia -usually
- inflammation - usually
- obstruction - sometimes
3 possible body responses to leaks
- acute inflammation
- lymphatics absorb>reticulo-endothelial uptake>blood
- systemic inflammation
functions of inflammation
- kills microbes
- fibrin deposition
pain
3 options once infected
- resolve - young and healthy
- perdistence - complex abdo
- death overwhelming ifection
common signs
- pain, tenderness, rebound
- ileus
- systemic fever, chills
3 exeptions to rule that all peritonitis is from gut
- pancreatitis
- ruptured AA
- primary peritonitis
2 times peritonitis may not need operation
- perforated ulcer
2. scope perf
prog. in 2ry peri
20-30% die
complications
- hernia
- renal fail
- pulmonary
- psych
what is the problem in diagnosing in people that are post-op
free air, pain are normal after abdo surg.
what can help diagnose atypical peritonitis
organ dysfunction - image liberally
7 keys to mgmt of infection
- don’t delay
- resuscitate - fluids BP
- source control - open or laprascopic
- manage abdo wall
- expect an treat complications
- ABs
- psych/fam
what to do for leak
hartmans
3 abdo wall challenges
- bowel edema
- heavy contamination
- weak tissues
3 possible residual wall problems
- fistula
- skin and fascia infections
- hernia
4 possible infectious complications
- pneu
- lines
- urinary
- skin
