Changes

Jump to navigation Jump to search
no edit summary
Line 12: Line 12:  
==Description==
 
==Description==
 
Peritonitis is defined as the inflammation of the peritoneum.  Peritonitis can be septic or non-septic.  Septic peritonitis results from free bacteria in the peritoneal cavity, caused by perforating injuries to the gastrointestnal tract due to foreign bodies, necrosis secondary to obstruction or intussusception.  Non-septic, also known as chemical peritonitis, may be the result of leakage of bile, urine or pancreatic enzymes.  However, non-septic peritonitis can cause septic peritonitis, for example cases where septic urine is present.
 
Peritonitis is defined as the inflammation of the peritoneum.  Peritonitis can be septic or non-septic.  Septic peritonitis results from free bacteria in the peritoneal cavity, caused by perforating injuries to the gastrointestnal tract due to foreign bodies, necrosis secondary to obstruction or intussusception.  Non-septic, also known as chemical peritonitis, may be the result of leakage of bile, urine or pancreatic enzymes.  However, non-septic peritonitis can cause septic peritonitis, for example cases where septic urine is present.
 +
    
==Diagnosis==
 
==Diagnosis==
Line 25: Line 26:  
===Laboratory Tests===
 
===Laboratory Tests===
 
====Haematology====
 
====Haematology====
 
+
*Significant leucocytosis or leucopaenia
    
====Biochemistry====
 
====Biochemistry====
*Significan leucocytosis or leucopaenia
   
*Hypoglycaemia
 
*Hypoglycaemia
 
*Increased lactate concentration
 
*Increased lactate concentration
   −
====Other Tests====
  −
*Abdominal fluid collected for laboartory analysis via abdominocentesis.  The fluid should be stained for intracellular bacteria and assessed for:
  −
**amylase and lipase for pancreatitis
  −
**bile for biliary leak
  −
**creatinine for urine
  −
**glucose (2.8 mmol/l) and lactate (>5.5 mmol/l) for sepsis
      
===Diagnostic Imaging===
 
===Diagnostic Imaging===
Line 45: Line 39:        +
===Histopathology===
 +
*Abdominal fluid collected for laboartory analysis via abdominocentesis.  The fluid should be stained for intracellular bacteria and assessed for:
 +
**amylase and lipase for pancreatitis
 +
**bile for biliary leak
 +
**creatinine for urine
 +
**glucose (2.8 mmol/l) and lactate (>5.5 mmol/l) for sepsis
 +
 +
==Treatment==
 +
It is vital to identify cases which require emergency surgical intervention.  Any of the following is a major indication:
 +
*positive for intracellular bacteria.
 +
*free gas visible in the abdominal radiograph.
 +
*presence of penetrating injuries in the abdomen.
   −
===Histopathology===
+
===Fluid therapy===
 +
*Aggressive fluid therapy with crystalloid and colloid should be given on initial presentation to improve haemodynamic parameter.
 +
*Fluid therapy is also very important in the postoperative period.
    +
===Analgesia===
 +
*Opiods should be given.
   −
==Treatment==
+
===Antimicrobial===
*It is vital to identify cases which require emergency surgical intervention.  Any of the following is a major indication:
+
*Broad spectrum antibiotics should be given, preferably following culture and sensitivity test.
**positive for intracellular bacteria.
  −
**free gas visible in the abdominal radiograph.
  −
**presence of penetrating injuries in the abdomen.
       
592

edits

Navigation menu