Gastroenterology - Diseases of the peritoneal cavity Flashcards
How does endometriosis affect the peritoneal cavity?
Ectopic endometrial tissue can become embedded on the serosal aspect of the sigmoid and rectum. Cyclical engorgement and inflammation causes low backache, bleeding, diarrhoea, constipation, adhesions or obstruction. It usually affects nulliparous women between 20 and 45 years old. Bimanual examination may reveal tender nodules in the pouch of Douglas. Sigmoidoscopy during menstruation reveals a bluish mass with intact overlying mucosa. Treatment options include laparoscopic diathermy and hormonal therapy with progestogens.
What conditions cause peritonitis? What is chlamydial peritonitis associated with?
Peritonitis usually occurs as the result of a ruptured viscus, but may also complicate ascites or occur in children without ascites, due to pneumococcal or streptococcal infection.
Chlamydial peritonitis is a complication of pelvic inflammatory disease, and presents with right upper quadrant pain, pyrexia, and a hepatic rub. TB may cause peritonitis and ascites.
What tumours affect the peritoneum?
The most common tumour is secondary adenocarcinoma from the ovary or GIT. Mesothelioma is a rare tumour complicating asbestos exposure. The prognosis is extremely poor.
