Peritonitis

Question 1

localised

Answer 1

occurs with all acute inflammatory conditions of GI tract

Question 2

Mx localised

Answer 2

depends on the underling condition e.g. acute appendicitis, acute cholecystitis

Question 3

Gerenalised

Answer 3

occurs due to rupture of an abd viscus e.g. perforated duodenal ulcer, perforated appendix

Question 4

Presentation of generalised

Answer 4

sudden onset of abd pain which rapidly becomes generalised

pt is shocked and lies still as movement exacerbates the pain

Question 5

Dx generalised peritonitis

Answer 5

plain AXR may show air under the diaphragm

serum amylase: to exclude acute pancreatitis

Question 6

Classification

Answer 6

onset: acute (most peritonitis)/chronic

source/origin: primary or secondary

cause: bacterial or chemical
location: localised or generalised

Question 7

what would absolute neutrophil count >250 cell/mm be?

Answer 7

SBP!!!

Question 8

Tx

Answer 8

resuscitate
ABC, antibiotics

treat the cause if primary peritonitis

surgical Tx: repair of perforated viscus - peptic ulcer