Peritonitis Flashcards
what is peritonitis
inflamed peritoneal cavity
what three nerves give sensation to the abdomen
splanchnic nerve
- greater (T5-9)
- lesser (T10-11)
- least (T12)
what are the three abdominal regions
epigastric (t5-9)
umbilical (t10-11)
hypogastric (t12)
what are the bacterial causes of peritonitis
Gram negative - E coli and klebsiella
Gram Positive - S Aureus
What are the chemical causes of peritonitis
Bile
Clotted blood
Ruptured ectopic pregnancy
Intestinal perforation
How does peritonitis present
Sudden severe abdo pain w/ collapse/septic shock Guarding helps (staying still) Ascites
What is a differential for severe abdominal pain but worse with laying still
Renal colic
How does localised peritonitis present
Inflamed parietal region w/ increased pain sensation
How does poorly localised peritonitis present
Inflamed visceral region w/ poor pain sensation
How can peritonitis be investigated
Ascitic tap -Neutrophilia -MC+S and causative organism b-HCG (Rule out ectopic preggo) Abdo XR (Rule out bowel obstruction) Erect CXR = air under diaphragm = perforated colon
How does a perforated colon present in erect CXR
Air under diaphragm
How is Peritonitis treated
ABCDE Treat cause (IV Fluid and IV Abx) Surgery = peritoneal lavage
What is the 1st line management for peritonitis
ABCDE
What is the definitive treatement for peritonitis
Peritoneal lavage
-Clean out Peritoneum
What are the main complications of peritonitis
Septicemia (Septic shock)
Pelvic abscess
