Exam 2: Peritonitis

Question 1

What is Peritonitis?

Answer 1

Inflammation of the peritoneum which is the serous membrane lining teh abdominal cavity and covering the viscera

Usually a result of bacterial infection but may occur secondary to a fungal or mcobacterial infections. Most common bacteria are E. Coli and Klebsiella, Proteus, Psueudomonas, and Streptococcus

Question 2

What can Peritonitis be categorized as?

Answer 2

Primary Peritonitis

Secondary Peritonitis

Tertiary Peritonitis

Question 3

Whaht is Primary Peritonitis

Answer 3

Occurs as a spontaneous bacterial infection of ascitic fluid. Occurs in those with liver failure

Question 4

What is Secondary Peritonitis

Answer 4

Occurs secondary to perforation of abdominal organs with spillage that infects the serous peritoneum.

Such as a appendix, perforated peptic ulcer, perforated sigmoid colon caused by severe diverticulitis, volvulus of the colon, and strangulation of the small intestine

Question 5

What is a Tertiary Peritonitis

Answer 5

Occurs as a result of a suprainfection in a patient who is immunocompromised.

Question 6

Assessment after this happens?

Answer 6

WBC count is elevated and increase in immature neutophils.

Hemoglobin Hematocrit may be low if blood loss occured.

Muscles become rigid. Rebound tenderness may be present. Increased temperature along with increased pulse rate as well

Question 7

Why is an abdominal xray useful and reveals?

Answer 7

May show air and fluid levels, as well as distended bowel loops

May also reveal abscesses(Localized collection of purulent material surrounded by inflamed tissues) and fluid colections and ultrasound-guided aspiration may assist in easier placement drains

Question 8

Medical Management

Answer 8

Administration of several liters of an isotonic solution. Hypovolemia occurs because massive amounts of fluid and electrolytes move from the intestinal lumen into the peritoneal cavity and deplete the fluid in the vascular space

Analgesic Medicatiosn prescribed for pain

Antibiotic Therapy started early

Question 9

What can be the main focus of treatent?

Answer 9

Excision (Appendix)

Resection with or without Anastomosis (Intestine)

Repair (Perforation)

Drainage (Abscess)

Question 10

Signs indicating that peritonitis is subsiding include

Answer 10

a decrease in temperature and pulse rate, softening of the abdomen, return of peristaltic sounds, passing of flatus, and bowel movements