Peritonitis Flashcards
What is peritonitis?
An acute or chronic inflammation of the peritoneum, typically caused by bacterial or fungal infection.
What are the most common causes of peritonitis?
- Bacterial or fungal infection
- Abdominal trauma or surgery
- Pancreatitis
- Cirrhosis with ascites
- Pelvic inflammatory disease
Which organisms are most commonly associated with peritonitis?
- E. coli
- Candida species
How does a bacterial infection typically enter the peritoneum?
Via perforation in the GI tract.
What is spontaneous bacterial peritonitis?
Also known as primary peritonitis; occurs without an identifiable source of infection in the abdomen.
What conditions are associated with primary peritonitis?
- Ascites
- Cirrhosis
- Nephrotic syndrome
What is secondary peritonitis?
Results from contamination from an intra-abdominal source.
What are common causes of secondary peritonitis?
- Perforation
- Postoperative complications
- Trauma
- Ischaemia
What is tertiary peritonitis?
Persistent or recurrent infection after adequate treatment for primary or secondary peritonitis.
Who is often affected by tertiary peritonitis?
Immunocompromised patients or patients in ICU.
What are the stereotypical clinical features of peritonitis?
- Acute abdominal pain (diffuse and severe)
- Nausea
- Vomiting
- Anorexia
What are some examination findings in peritonitis?
- Abdominal distension
- Peritoneal signs (rebound tenderness, guarding, rigidity)
- Decreased bowel sounds
What is the threshold neutrophil count in ascitic fluid analysis indicating spontaneous bacterial peritonitis?
Neutrophils >250.
What imaging findings are associated with peritonitis?
- Free fluid in cavity
- Free air under diaphragm
What are the initial steps in the management of peritonitis?
- Initial assessment & resuscitation
- Antibiotic therapy (broad-spectrum)
- Surgical intervention (if indicated)
What are potential complications of peritonitis?
- Septic shock
- Abscess formation
- Intra-abdominal adhesions
- Hepatic encephalopathy
- Acute respiratory distress syndrome
- Acute kidney injury
- Prolonged ileus
