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Peritonitis (Clinical Presentation (Lying still - people with peritonitis…
Peritonitis
Clinical Presentation
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Poorly localised (of visceral peritoneum) then moving to one point on abdominal and becoming localised (of parietal peritoneum)
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When peritonitis is secondary to inflammatory disease, the onset is less rapid with the initial features being those of the underlying disease
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Treatment
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ABC (airways, breathing, circulation)
Surgery
- Peritoneal lavage (cleaning) of abdominal cavity
- Specific treatment of the underlying condition
Complications
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Local abscess formation can occur and should be suspected if a patient continues to remain unwell post-op, with a swinging fever, high white cell count and continuing pain
Paralytic ileus
Peristaltic waves in colon stop leading to fluid strangulation causing distended gut and bloating which puts pressure on stomach and interferes with diaphragm and thus breathing - causes patient to breathe less deeply which promotes infection as bacteria can remain deep in lungs as they are not exhaled
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Main Causes
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Chemical
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Mode of action - chemical irritation due to leakage of intestinal contents, ruptured ectopic pregnancy - with blood release
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In general, peritonitis tends to be caused mainly by bacteria
Key Facts
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Physiology
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Visceral
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On organs e.g. stomach, liver and colon
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Classification
Primary
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Inflammation on its own - spontaneous bacterial peritonitis, ascites
Secondary
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Treat the cause, primarily via surgery