Endotox, Peritonitis and Adhesions

Question 1

What is the toxic principle of the endotoxin?

Answer 1

Lipid A

Question 2

What can increase gastric permeability?

Answer 2

• GIT rupture
• Local ischaemia
• Inflammation
• Systemic acidosis

Question 3

What are the treatment strategies for endotoxaemia?

Answer 3

1. Inhibition of LPS release into circulation (antimicrobials)
2. Scavenging of LPS to prevent direct effects and interaction with inflammatory cells (Polymixin B)
3. Inhibition of cellular activity by LPS (Ethyl Pyruvate)
4. Inhibition of mediator synthesis (NSAIDs and antioxidants)
5. Interference with effects of inflammatory mediators (experimental)
6. Supportive care

Question 4

What can analysis of the glucose content of peritoneal fluid tell you?

Answer 4

If glucose in peritoneal fluid is less than half the systemic plasma, that tells you there are bacteria present in the peritoneal cavity using the glucose for energy.