Peritonitis

Question 1

What is the peritoneum?

Answer 1

the inner membrane that lines the abdominal cavity and abdominal organs

Question 2

What are the two types of peritonitis:

Answer 2

1) spontaneous bacterial peritonitis
2) secondary peritonitis

Question 3

What is the most common cause of spontaneous bacterial peritonitis?

Answer 3

a spontaneous infection of the ascites fluid that has built up as a result of liver or kidney failure

Question 4

What is the most common cause of secondary peritonitis?

Answer 4

a ruptured organ in the abdomen which allows bacteria to enter the peritoneal cavity (appendicitis, pancreatitis, diverticulitis, ruptured stomach ulcer, perforated colon)

Question 5

Other than organ rupture, give 3 other causes of secondary peritonitis:

Answer 5

1) trauma
2) GI surgery
3) peritoneal dialysis

Question 6

Give 5 core clinical features of peritonitis:

Answer 6

1) severe abdominal pain
2) nausea and vomiting
3) loss of appetite
4) diarrhoea
5) fever

Question 7

What is the key examination finding characteristic of peritonitis?

Answer 7

guarding/ Rebound tenderness/ Percussion tenderness

Question 8

What dialysis finding indicates peritonitis?

Answer 8

cloudy dialysis fluid

Question 9

Does peritonitis have an acute or chronic onset?

Answer 9

Acute

Question 10

What are the 3 main management steps used to treat secondary peritonitis?

Answer 10

1) supportive management (analgesia, fluids, oxygen)
2) antibiotics (determined by severity and cause)
3) surgery (to remove the source of infection and control its spread)

Question 11

What recommendation regarding dialysis use is made when a patient presents with peritoneal dialysis associated peritonitis?

Answer 11

switch to another form of dialysis until the infection has healed

Question 12

What is peritoneal dialysis?

Answer 12

where the peritoneum is used as a natural filter of blood in end stage renal failure, where a catheter is inserted into the abdomen to introduce fluid that absorbs waste and excess fluid from the blood which is later discarded

Question 13

What is peritonitis?

Answer 13

Inflammation of the peritoneum

• peritoneum = serous membrane lining the cavity of the abdomen, covering the abdominal organs

Question 14

What are the 2 main causes of peritonitis and examples of each?

Answer 14

1. infection

• spontaneous bacterial peritonitis
• peritoneal infection secondary to peritoneal dialysis
• uncomplicated appendicitis

2. perforation of a hollow viscus

• perforated oesophagus
• perforated gastric or duodenal ulcer

Question 15

What should be initiated in patients with suspected peritonitis?

Answer 15

SEPSIS 6

• due to being systemically very unwell

Question 16

What are some differential diagnosis for peritonitis?

Answer 16

• gastroenteritis
• Pancreatitis
• Cholecystitis
• Appendicitis
• Diverticulitis

Question 17

What are the complications of peritonitis?

Answer 17

• sepsis
• local abscess
• death