Peritonitis

Question 1

what is a leading sign of rupture of an organ?

Answer 1

Shock with abdominal swelling

Question 2

what is peritonitis

Answer 2

inflammation of peritonuem

Question 3

what are the signs of peritonitis?

Answer 3

LYING STILL
rebound tenderness
+ve cough test (if they move their hands towards abdomen/in pain)

Question 4

what would you see on erect CXR for peritonitis?

Answer 4

gas under diaphragm (pneumoperitoneum) -

Question 5

two types of peritonitis

Answer 5

localised and generalised

Question 6

localised peritonitis?

seen in which conditions?

features?

Answer 6

inflammation of single viscera

appendicitis
diverticulitis
cholecystitis

abdo pain
tenderness
guarding
all LOCAL ^^

Question 7

Generalised peritonitis?

features?

Answer 7

widespread inflam of peritoneal lining

laying still 
washboard rigidity 
guarding 
rebound tenderness 
hypovolaemic shock

Question 8

management for generalised peritonitis?

Answer 8

resuscitate with IV fluids
infuse IV Abx
prompt laparotomy (peritoneal washout + treatment of cause)

Question 9

when is laparotomy not required?

Answer 9

Local Peritonitis
o E.g. Diverticulitis, Cholecystitis
o If abscess formation is suspected (swelling, swinging fever + ^WCC) do US/CT.
o Drainage can be percutaneous (US/CT guided) or laparotomy.