Acute Peritonitis

Question 1

Types of acute peritonitis

Answer 1

Primary
Secondary
Tertiary

Question 2

Main population at the risk of primary peritonitis

Answer 2

Young Girls 3 to 10 years
sometimes boys

Patients with cirrhosis with ascites or nephrotic syndrome ( E. coli, strep)

Question 3

Route of spread of organism for primary peritonitis

Answer 3

Vagina
hematogenous

Question 4

Main organisms involved in primary peritonitis

Answer 4

Strep pneumoniae
Strep pyogenes

Question 5

Main presentation of primary peritonitis

Answer 5

Sticky creamy or a greenish pus

Question 6

Two types of secondary peritonitis

Answer 6

Localized
generalized

Question 7

Causes of generalized secondary peritonitis

Answer 7

penetrating injury
inflammation of intra-abdominal viscus
perforation
leakage /perforation of abscess
intestinal obstruction
aftermath of abdominal surgery
septicemia

Question 8

Disease causing inflammation of intra-abdominal viscus

Answer 8

Acute appendicitis
cholecystitis
diverticulitis
pancreatitis

Question 9

Causes of perforation leading to secondary peritonitis

Answer 9

Perforated peptic ulcer
typhoid perforation
amoebic colitis perforation
appendicitis
colonic tumors
penetrating injury is

Question 10

Causes of intestinal obstruction leading to generalize secondary peritonitis

Answer 10

Translocation of the bacteria

strangulation of bowel (adhesions ,bands, hernias, tumors ,volvulus)

Question 11

What is tertiary peritonitis

Answer 11

Intra-abdominal infection that persists or recurs 48 hours following successful and adequate surgical source control

Question 12

Causes of tertiary peritonitis

Answer 12

Break in aseptic technique
contaminated surgery
Leakage or breakdown of anastomosis
septic focus

Question 13

Clinical features of peritonitis

Answer 13

Inflammation of parietal peritoneum with intense constant localized pain
visceral dull , colicky, vague pain

Anorexia,nausea

Vomiting

Constipation
Concentrated
Scanty urine
Fever
Abdominal distension

Question 14

Complications of peritonitis

Answer 14

Absorption of toxins and bacteria paralytic ileus
fluid And electrolyte imbalance
cardio respiratory failure acid-base disturbances
pre-renal failure
acute tubular necrosis
sepsis with multiple organ failure

Question 15

Causes of death in peritonitis

Answer 15

Shock
dehydration
electrolytes disturbances
acidosis
septicemia
liver failure
renal failure
multiple organ failure

Question 16

Signs of peritonitis

Answer 16

Patient ill looking
Furred tongue and dry
Dry skin , loss of turgor
Rapid pulse , thready
Pyrexia
Tender, rebound tenderness abdomen
Rectal examination

Question 17

Investigations of peritonitis

Answer 17

Abdominal x ray
CT scan
Ultrasound scan
FBC
BUE , creatinine
Urine RE

Question 18

Principles of treatment of peritonitis

Answer 18

Resuscitation
Rest of bowel
Antibiotics
Analgesics
Surgery for underlying problem correction