Acute abdo - peritonitis Flashcards
1
Q
cirrhosis patient with ascites who deteriorates suddenly with Sx of fever, V, abdo pain?
A
SBP - Abx
2
Q
causes of peritonitis?
A
perforated ulcer/ diverticulum/ appendix/ bowel/ GB
3
Q
Hx - lying still, prostration, board-like rigidity, guarding, +ve cough test (causes flinching or guarding) and tenderness to palpation (+/- rebound/percussion pain)?
+/- generalised: absent bowel sounds and shock (↑RR, ↑HR, ↓BP)
A
peritonitis
check amylase - can be similar to acute pancreatitis
4
Q
CXR showing gas under diaphragm?
A
peritonitis
5
Q
Tx peritonitis?
A
laparotomy
6
Q
bacteria normally causing SBP?
A
E.coli (also klebsiella)
7
Q
if ascitic fluid has >250 neutrophils/ul?
A
SBP
8
Q
Tx SBP?
A
co-amox, pip/taz IV if severe
9
Q
ΔΔ peritonitis + rigors?
A
- cholangitis
- pyelonephritis
- intra-abdominal abscess
