Peritonitis Flashcards
Palpate the left but patient feels pain on the right
Rovsing’s sign
Only elicited in males. Drag on the testes. Drag on right and pain feels pain in the right iliac fossa
Ten horn sign
Endoscopy is contraindicated in a ………….
Perforated hollow viscus
Hold the waist of a supine lying patient, Tell them to shake it. A peritonitis patient will not allow you
Jar sign
What is the most common pathogen for peritonitis
Bacteria
Peritonitis and intra-abdominal infections are not synonymous
True or false
True
What is the difference between peritonitis and intra-abdominal infection
Peritonitis may result from sterile inflammation of the peritoneum while infra-abdominal infection implies inflammation of the peritoneum caused by microorganisms
What is an abscess
Accumulation of pus in a cavity
What is a phlegmon
Diffused spread of pus because of the absence of a cavity
What are some pathways leading to peritoneal infections
Gastrointestinal perforation
Exogenous contamination
Transmural translocation
Ascending female genital tract infection
Hematogenous spread
What is localized peritonitis
A type of peritonitis limited it confined to a demarcated area or region
What is generalized/diffuse peritonitis
Widespread peritonitis throughout
What are some factors affecting localization
Anatomical
Pathological
Surgical
What is the most important structure in closing the abdomen
The fascia (not the oeritoneum)
What are some factors favoring diffuse peritonitis
Speed of contamination
Peristalsis
Virulence
Young children
Immunodeficiency
What is the most common pathogen for peritonitis
Bacteria
Mostly polymicrobial, both aerobes and anaerobes
What could produce endotoxic shock with hypotension
Endotoxins released by gram negative bacteria
What is a resectable intra-abdominal infection
They are infectious processes that are contained within a diseased but resectable organ (e.g. gangrenous appendix). These conditions are easily eradicated by an operation and consequently do not require prolonged postoperative antibiotic therapy
What is a non-resectable intra-abdominal disease
They are infections that have spread beyond the confines of the source organ. In perforated appendix, for instance, you may resect the appendix but residual peritoneal infection persists, requiring extended antibiotic coverage
What cells form the peritoneum
A single layer of polyhedral cells on thin fibro elastic tissue
What is the largest cavity of the body
Peritoneal cavity
What is the area of the peritoneal cavity
1.7 m2
What are the functions of the peritoneum
Pain perception
Visceral lubrication
Fluid and particulate absorption
Inflammatory and immune responses
Fibrinolytic activity
What are some examples of GI perforation
Perforated ulcer
Diverticula perforation
What are some sources of exogenous contamination
Surgical drains
Surgeries
Traumas
What are some examples of female genital tract infections
PID
Infected IUCD
What could be an example of hematogenous spread
Septicemia
What are some examples of transmural translocation
IBD
Appendicitis
Ischemic bowel
Peritonitis as a disease is classified based on
Severity
Extent/Spread
Cause
Under severity, peritonitis could be subcategorised into
Mild
Moderate
Severe
Under extent/spread, peritonitis can be subcategorised into
Localized
Generalized
