Peritonitis

Question 1

What is peritonitis?

Answer 1

Inflammation of the peritoneum associated with rupture of an internal organ. SURGICAL EMERGENCY.

Question 2

What is infected peritonitis and how can it occur?

Answer 2

Perforation of GIT or repro system from trauma or an ulcer etc.
External bacteria getting in from environment in surgery or trauma.
Spontaneous bacterial peritonitis can occur in children or those with ascites.

Question 3

What is non-infected peritonitis and how can it occur?

Answer 3

Autoimmune e.g. SLE.

Sterile bodily fluids e.g. blood and bile can get into the peritoneum. They will become infected within 48 hours.

Question 4

How does peritonitis present?

Answer 4

Sudden onset acute abdo pain.
Pain is made worse by any movement e.g. coughing, which leads to washboard rigidity.
Initially is a generalised pain but it localises as parietal fibres become involved.
Shock.
Fever.
Tachycardia.

Question 5

What are the potential complications of peritonitis?

Answer 5

Fluid loss and electrolyte disturbance.
Breathing difficulties (diaphragm under pressure).
Abscess formation.

Question 6

How is peritonitis managed?

Answer 6

IV fluids, electrolytes and antibiotics.

Laparotomy to repair perforation and wash out peritoneum.