Peritonitis

Question 1

What is peritonitis?

Answer 1

Inflammation of the peritoneum.

Question 2

What are the risk factors of peritonitis?

Answer 2

Ascites, stomach ulcers, pelvic inflammatory disease, decompensated hepatic state
E.Coli and S.Aureus

Question 3

What are the signs and symptoms of peritonitis?

Answer 3

Bloating
Nausea
Vomiting
Fever
Diarrhoea
Decreased urine output
Pain/ tenderness

Secondary peritonitis may cause more rigidity

Question 4

What is the epidemiology of SBP?

Answer 4

SBP- 12% in patients with ascites from decompensated cirrhosis

Question 5

What investigations may be important for peritonitis?

Answer 5

>Bloods
FBC
Cr
LFT
INR/PT
Culture
ABG-pH

>Ascitic fluid
Neutrophil count
Gram stain
Culture
Leukocyte esterase
pH

> Urine
Leukocyte esterase strip

Question 6

How do you manage peritonitis?

Answer 6

Antibiotics
Albumin
Large volume paracentesis
Supportive therapy

Question 7

What are the complications of peritonitis?

Answer 7

Sepsis
Tense ascites
Paracentesis- bleeding, perforation or leakage
Renal failure

Question 8

What is the prognosis of peritonitis?

Answer 8

High chance of recurrence
Renal dysfunction is prognostic
Low mortality if treated