peritonitis Flashcards
T/F
focal contamination of the peritoneum quickly inoculates the entire pertioneum
yes
a cranially located source takes __ min to inoculate the peritoneum
19 min
a caudally located source takes __ min to inoculate the peritoneum
72min
classification of peritonitis
spontaneous inflammation in the absence of intraperitoneal source
primary
peritonitis that is usually gram positive and monobacterial
primary
peritonitis that is mostly gram negative and polymicrobial
secondary
T/F
primary peritonitis is more common than secondary
false – secondary is more common - it is the consequence of an underlying primary disease
septic peritonitis
infectious etiologies present
T/F
surgery is not routinely indicated for secondary peritonitis but is a requisite for primary
false - opposite!!
must differentiate primary vs secondary
Gi origin accounts for what percentage of septic peritonitis
38-75%
this drug has the tendency to cause proximal duodenal peritonitis
deramaxx - NSAIDS
steroids cause peritonitis in what part of the GI
proximal descending colon
T/F
the more aboral the higher the bacterial counts and higher the anaerobes and higher the mortality
TRUE
two biggest offenders of septic peritonitis in the bowel
Ecoli - alpha hemolysin tox
bascteriodes fragilus - anaerobe that enhances the lethal potential of ecoli
hepatbiliary causes of septic peritonitis
ruptured gall bladder
necrotizing cholecystitis
urogenital septic peritonitis
pyometra
penetrating trauma that can cause septic peritonitis
bites
terminal effects
DIC
sIRS
MODS
hyperdynamic shock
vasomotor dysfunction cytokine induced peripheral vasodilation tachycardia hyperemic mm rapid CRT bounding pulses hyperthermia
hypodynamic shock
decreased contractility and CO pale mm and low CRT weak peripheral pulses high RR and HR hypothermia dehydrated dull mentation
classic peritonitis signs
painful
vomiting
fever
distended abdomen and maybe shock
T/F
cats are painful on abdominal palpation in septic peritonitis cases
FALSE
describe relative bradycardia in cats
< 140 bpm
inappropriately low for a hemodynamic state of cat
How long can residual air remain after abdominal surgery
30days
preferred dx technique in people
CT
gold standard DX for peritonitis
cytology - ultrasound guided aFAST
what is seen on cytology
degenerative neutrophils with intracellular bacteria
what is the accuracy of cytology
57 - 87 % accurate
dogs with septic effusion
the peritoneal fluid glucose conc will always be ____ than the blood glucose concentration
20 points lower
the peritoneal fluid lactate will always be ____ than blood lactate
2 points higher
diagnostic for uroperitoneum
peritoneal fluid CREA > serum CREA
bile peritonitis DX
peritoneal fluid bilirubin will be > 2.5 times the serum bilirubin concentration
four quadrant treatment
IV ampicillin
baytril
metonidazole
if aminoglycoside is used instead of baytril be careful because it can potentiate renal failure in patients with poor perfusion
lavage surgery with ____
WARM isotonic saline
critical aspects of post op care in peritonitis
enteral nutrition – these animals need feeding tubes
drainage po is CRITICAL
most efficient way to drain
open
peritoneal drain with lower risk of evisceration
closed
drain that limits anaerobic growth
open
drain that requires a longer hospital stay anf more intensive care
open
drain of choice for abdominal drainage
active drain - jackson pratt
best type of feeding tube
combo G and J – gastrojejunostomy
prognosis for young stable patient with acute onset
80:20 chance living
prognosis for ill patient with unknown source peritonitis
50:50
negative risk factors
decreased blood pressure pre, intra, or post op
presence of DIC
ineffective ABx used
