Difference between revisions of "Peritonitis"
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− | + | ===Classification=== | |
+ | [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=1262 Image of acute fibrinous peritonitis from Cornell Veterinary Medicine] | ||
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− | + | *Usually '''secondary''' to other abdominal pathology but may be '''primary''' | |
− | + | *'''Localised''' or '''diffuse''' | |
+ | *'''Acute''' (increased fluid in abdominal cavity and roughening of serosal surface of abdominal organs and [[Peritoneal cavity - Anatomy & Physiology|parietal peritoneum]]) or '''chronic''' (fibrous adhesions involving any of abdominal organs and omentum/mesentery/[[Peritoneal cavity - Anatomy & Physiology|peritoneum]]) | ||
+ | *'''Septic''' or '''non-septic''' | ||
+ | *Types of exudate | ||
+ | **'''Sero-fibrinous''' e.g. Glasser’s disease (''[[Haemophilus parasuis]]'') in pigs | ||
+ | **'''Fibrinopurulent''' e.g. after gut rupture, systemic infection ([[:Category:Pasteurella and Mannheimia species|pasteurellosis in sheep]]) | ||
+ | **'''Purulent''' e.g. [[Rhodococcus equi|''Rhodococcus equi'']] in foals | ||
+ | **'''Haemorrhagic''' e.g. splenic rupture | ||
+ | **'''Granulomatous''' e.g. ''[[:Category:Nocardia species|Nocardia]]'' in dogs | ||
− | + | ===Causes of peritonitis=== | |
− | + | ====Chemical==== | |
− | + | [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=3048 Image of bile stained peritonitis in a cat from Cornell Veterinary Medicine] | |
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− | + | e.g.: | |
+ | *Bile | ||
+ | *Urine | ||
+ | *[[Pancreas - Anatomy & Physiology#Exocrine Function|Pancreatic enzymes]] ([[Pancreatic Necrosis, Acute|acute pancreatic necrosis]]) | ||
+ | *Barium if allowed to leak into peritoneal cavity (causes potentially fatal haemorrhagic peritonitis) | ||
+ | *Surgical glove powder (granulomatous peritonitis) | ||
+ | *Chyle (mild granulomatous serositis) | ||
− | == | + | ====Bacterial==== |
− | + | [[Image:Tubeculous peritonitis.jpeg|right|thumb|125px|<small><center> Tuberculous peritonitis with phagocytosis of lymphocytes (Sourced from Bristol Biomed with permission)</center></small>]] | |
− | + | e.g.: | |
− | + | *Penetrating wound | |
+ | *Gut rupture | ||
+ | *Surgery | ||
+ | *Inflammatory focus e.g. abscess, bacteraemia | ||
+ | *Umbilicus | ||
+ | *Gangrenous intestine or uterus prior to rupture | ||
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− | ==== | + | ====Viral==== |
− | [ | + | [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=11598 Image of FIP by Cornell Veterinary Medicine] |
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− | + | e.g. | |
+ | *[[Feline Infectious Peritonitis|Feline infectious peritonitis]] - in “wet” (effusive) form, sero-fibrinous fluid with high protein (Ig content), tags of fibrin attach to [[Peritoneal cavity - Anatomy & Physiology|peritoneum]] and organs | ||
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− | ==== | + | ====Parasites==== |
− | + | e.g. | |
+ | *Strongyle migration in horses | ||
+ | *[[Trematodes|Fasciola hepatica]] - lesions around [[Liver - Anatomy & Physiology|liver]] | ||
+ | *See [[Peritoneal Cavity - Parasitic Pathology|Peritoneal Cavity Parasitic]] | ||
− | + | ===Sequelae to peritonitis=== | |
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− | == | ||
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+ | *Hypermotility initially → hypomotility | ||
**Ileus - reduces distribution of exudates by intestinal motility | **Ileus - reduces distribution of exudates by intestinal motility | ||
**Fibrinous adhesions may develop | **Fibrinous adhesions may develop | ||
*Impaired CV function and acid-base imbalance | *Impaired CV function and acid-base imbalance | ||
− | **Due to sequestration of fluid and protein in exudate, hypomotile gut, bacterial exo/endotoxins absorbed directly from [[Peritoneal | + | **Due to sequestration of fluid and protein in exudate, hypomotile gut, bacterial exo/endotoxins absorbed directly from [[Peritoneal cavity - Anatomy & Physiology|peritoneal cavity]] and causing vascular permeability, loss of intestinal absorption |
*May resolve, become chronic-active or lead to adhesions. | *May resolve, become chronic-active or lead to adhesions. | ||
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− | In | + | ===In dogs=== |
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+ | *Fibrinohaemorrhagic peritonitis in infectious canine hepatitis | ||
+ | *Septic peritonitis caused by various agents, often [[Escherichia coli|''Escherichia coli'']] and anaerobic bacteria through perforation of the gut, rupture of [[Urinary Bladder - Anatomy & Physiology|urinary bladder]] or an abscess | ||
+ | *Putrid peritonitis in uterine rupture with pyometra or septic metritis | ||
+ | *''[[:Category:Nocardia species|Nocardia]]'' infection reults in profuse pink/red fluid due to blood and chronic inflammatory cells | ||
+ | *Granulomatous peritonitis caused by [[Fungi|fungi]], ''[[:Category:Nocardia species|Nocardia]]'' and ''[[:Category:Actinomyces|Actinomyces]]'' | ||
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+ | ===In cats=== | ||
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+ | *Putrid peritonitis in uterine rupture due to pyometra or fetal putrefaction | ||
+ | *Peritonitis due to penetrating wounds | ||
+ | *Septic peritonitis due to anaerobes in cat bite abscesses | ||
+ | *Serous peritonitis in cats with [[Feline Infectious Peritonitis|feline infectious peritonitis]] especially in the wet form but exudate occurs also in the dry form | ||
+ | **Viscous, clear, pale to deep yellow fluid, may contain strands of fibrin | ||
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− | === | + | ===In horses=== |
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− | [ | + | [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=6111 Image of acute fibrinous peritonitis in a horse from Cornell Veterinary Medicine] |
− | + | *Diffuse acute peritonitis often fatal | |
+ | *Mostly caused by rupture of [[Forestomach - Anatomy & Physiology|stomach]] or intestine | ||
+ | *In foals purulent peritonitis may be caused by [[Rhodococcus equi|''Rhodococcus equi'']] or fibrinous peritonitis by ''[[Actinobacillus equuli]]'' | ||
+ | *Haemorrhage as a consequence of castration may result in acute non-septic | ||
+ | *Secondary to [[Peritoneal Cavity - Parasitic Pathology|verminous lesions]] | ||
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− | === | + | ===In cattle=== |
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− | + | *Perforation of an abdominal organ, usually [[The Reticulum - Anatomy & Physiology|reticulum]] or [[[[Female Reproductive Tract -The Uterus - Anatomy & Physiology|uterus]], results in acute diffuse fibrinopurulent peritonitis or local acute and chronic, with adhesions | |
+ | *[[Traumatic Reticulitis|Traumatic reticuloperitonitis]] (hardware disease) may evolve into reticulopericarditis | ||
+ | *Local chronic peritonitis, abscesses containing usually ''[[Actinomyces pyogenes]]'' | ||
+ | *Fibrinopurulent peritonitis through umbilical infection in calves | ||
+ | *Fibrinous peritonitis in calves with septicaemic colibacillosis | ||
+ | *Serofibrinous peritonitis in sporadic bovine encephalomyelitis | ||
+ | *Diffuse fibrinohaemorrhagic peritonitis in clostridial haemoglobinuria | ||
+ | *Localised peritonitis in [[Septicaemia and Enteritis, Bacterial|clostridial enterotoxaemia]] ([[:Category:Enteropathogenic and Enterotoxaemic Clostridia|''Clostridium perfringens'' types B and C]] and braxy) | ||
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− | + | ===In sheep=== | |
− | + | *Fibrinopurulent peritonitis in postpartum septic metritis | |
− | + | *Serofibrinous peritonitis in diseases caused by [[:Category:Mycoplasmas|''Mycoplasma'']] | |
− | + | *In penetration of intestines by larvae of [[Strongyloidea|''Oesophagostomum columbianum'']] | |
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− | == | + | ===In goats=== |
− | + | *Acute fibrinous peritonintis caused by [[Mycoplasma mycoides subsp. mycoides|''Mycoplasma mycoides'']] | |
− | + | ===In pigs=== | |
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− | + | *Diffuse fibrinopurulent peritonitis in infections by ''[[Actinomyces pyogenes]]'', [[Escherichia coli|''Escherichia coli'']] or other organisms | |
− | + | *Serofibrinous peritonitis in Glasser’s disease ''[[Haemophilus parasuis]]'' or [[:Category:Mycoplasmas|''Mycoplasma'']] or septicaemias caused by ''[[Streptococcus suis]]'' type 2 | |
+ | *Acute gelatinous haemorrhagic peritonitis in [[Bacillus anthracis|Anthrax]][[Category:Peritoneal Cavity - Inflammatory Pathology]] |
Revision as of 15:10, 10 June 2010
Classification
Image of acute fibrinous peritonitis from Cornell Veterinary Medicine
- Usually secondary to other abdominal pathology but may be primary
- Localised or diffuse
- Acute (increased fluid in abdominal cavity and roughening of serosal surface of abdominal organs and parietal peritoneum) or chronic (fibrous adhesions involving any of abdominal organs and omentum/mesentery/peritoneum)
- Septic or non-septic
- Types of exudate
- Sero-fibrinous e.g. Glasser’s disease (Haemophilus parasuis) in pigs
- Fibrinopurulent e.g. after gut rupture, systemic infection (pasteurellosis in sheep)
- Purulent e.g. Rhodococcus equi in foals
- Haemorrhagic e.g. splenic rupture
- Granulomatous e.g. Nocardia in dogs
Causes of peritonitis
Chemical
Image of bile stained peritonitis in a cat from Cornell Veterinary Medicine
e.g.:
- Bile
- Urine
- Pancreatic enzymes (acute pancreatic necrosis)
- Barium if allowed to leak into peritoneal cavity (causes potentially fatal haemorrhagic peritonitis)
- Surgical glove powder (granulomatous peritonitis)
- Chyle (mild granulomatous serositis)
Bacterial
e.g.:
- Penetrating wound
- Gut rupture
- Surgery
- Inflammatory focus e.g. abscess, bacteraemia
- Umbilicus
- Gangrenous intestine or uterus prior to rupture
Viral
Image of FIP by Cornell Veterinary Medicine
e.g.
- Feline infectious peritonitis - in “wet” (effusive) form, sero-fibrinous fluid with high protein (Ig content), tags of fibrin attach to peritoneum and organs
Parasites
e.g.
- Strongyle migration in horses
- Fasciola hepatica - lesions around liver
- See Peritoneal Cavity Parasitic
Sequelae to peritonitis
- Hypermotility initially → hypomotility
- Ileus - reduces distribution of exudates by intestinal motility
- Fibrinous adhesions may develop
- Impaired CV function and acid-base imbalance
- Due to sequestration of fluid and protein in exudate, hypomotile gut, bacterial exo/endotoxins absorbed directly from peritoneal cavity and causing vascular permeability, loss of intestinal absorption
- May resolve, become chronic-active or lead to adhesions.
In dogs
- Fibrinohaemorrhagic peritonitis in infectious canine hepatitis
- Septic peritonitis caused by various agents, often Escherichia coli and anaerobic bacteria through perforation of the gut, rupture of urinary bladder or an abscess
- Putrid peritonitis in uterine rupture with pyometra or septic metritis
- Nocardia infection reults in profuse pink/red fluid due to blood and chronic inflammatory cells
- Granulomatous peritonitis caused by fungi, Nocardia and Actinomyces
In cats
- Putrid peritonitis in uterine rupture due to pyometra or fetal putrefaction
- Peritonitis due to penetrating wounds
- Septic peritonitis due to anaerobes in cat bite abscesses
- Serous peritonitis in cats with feline infectious peritonitis especially in the wet form but exudate occurs also in the dry form
- Viscous, clear, pale to deep yellow fluid, may contain strands of fibrin
In horses
Image of acute fibrinous peritonitis in a horse from Cornell Veterinary Medicine
- Diffuse acute peritonitis often fatal
- Mostly caused by rupture of stomach or intestine
- In foals purulent peritonitis may be caused by Rhodococcus equi or fibrinous peritonitis by Actinobacillus equuli
- Haemorrhage as a consequence of castration may result in acute non-septic
- Secondary to verminous lesions
In cattle
- Perforation of an abdominal organ, usually reticulum or [[uterus, results in acute diffuse fibrinopurulent peritonitis or local acute and chronic, with adhesions
- Traumatic reticuloperitonitis (hardware disease) may evolve into reticulopericarditis
- Local chronic peritonitis, abscesses containing usually Actinomyces pyogenes
- Fibrinopurulent peritonitis through umbilical infection in calves
- Fibrinous peritonitis in calves with septicaemic colibacillosis
- Serofibrinous peritonitis in sporadic bovine encephalomyelitis
- Diffuse fibrinohaemorrhagic peritonitis in clostridial haemoglobinuria
- Localised peritonitis in clostridial enterotoxaemia (Clostridium perfringens types B and C and braxy)
In sheep
- Fibrinopurulent peritonitis in postpartum septic metritis
- Serofibrinous peritonitis in diseases caused by Mycoplasma
- In penetration of intestines by larvae of Oesophagostomum columbianum
In goats
- Acute fibrinous peritonintis caused by Mycoplasma mycoides
In pigs
- Diffuse fibrinopurulent peritonitis in infections by Actinomyces pyogenes, Escherichia coli or other organisms
- Serofibrinous peritonitis in Glasser’s disease Haemophilus parasuis or Mycoplasma or septicaemias caused by Streptococcus suis type 2
- Acute gelatinous haemorrhagic peritonitis in Anthrax