674
edits
Changes
no edit summary
See also: [[Peritonitis - Cats and Dogs|Peritonitis in Dogs and Cats]]
==Description==
==Introduction==
Peritonitis refers to [[Inflammation - Pathology|inflammation]] of the [[Peritoneal cavity - Anatomy & Physiology|peritoneal cavity]] and it may occur in any of the domestic species. Peritonitis represents a considerable therapeutic challenge in any species and frequently carries a very poor prognosis.
Peritonitis refers to [[Inflammation - Pathology|inflammation]] of the [[Peritoneal Cavity - Anatomy & Physiology|peritoneal cavity]] and it may occur in any of the domestic species. Peritonitis represents a considerable therapeutic challenge in any species and frequently carries a very poor prognosis.
==Classification==
==Classification==
*'''Granulomatous''', as with ''[[:Category:Nocardia species|Nocardia]]'' infection in dogs
*'''Granulomatous''', as with ''[[:Category:Nocardia species|Nocardia]]'' infection in dogs
Peritonitis may occur acutely or it may be a chronic process that reaches an advanced stage before it is diagnosed. In cases of '''acute''' peritonitis, there is likely to be an increased amount of fluid in the peritoneal cavity and roughening of serosal surface of the abdominal organs and [[Peritoneal cavity - Anatomy & Physiology|parietal peritoneum]] due to the presence of fibrin. Cases of '''chronic''' peritonitis often involve fibrous adhesions between any of the abdominal organs and the omentum, mesentery or [[Peritoneal cavity - Anatomy & Physiology|peritoneum]].
Peritonitis may occur acutely or it may be a chronic process that reaches an advanced stage before it is diagnosed. In cases of '''acute''' peritonitis, there is likely to be an increased amount of fluid in the peritoneal cavity and roughening of serosal surface of the abdominal organs and [[Peritoneal Cavity - Anatomy & Physiology|parietal peritoneum]] due to the presence of fibrin. Cases of '''chronic''' peritonitis often involve fibrous adhesions between any of the abdominal organs and the omentum, mesentery or [[Peritoneal Cavity - Anatomy & Physiology|peritoneum]].
==Causes of Peritonitis==
==Causes of Peritonitis==
====Chemical Peritonitis====
====Chemical Peritonitis====
Chemical peritonitis occurs when irritant fluids effuse or leak into the peritoneal cavity. [[Biliary Tract - Rupture|Rupture of the biliary tract]] results in the leakage of '''bile''' into the abdomen. Initially, this causes few clinical signs but over time, it irritates the visceral and parietal peritoneum and causes them to become inflamed. If the biliary tract is infected at the time of rupture, a septic peritonitis may develop. The parietal peritoneum and abdominal organs are typically stained green by the presence of bile. An image of bile peritonitis in a cat is available [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=3048 here].
Chemical peritonitis occurs when irritant fluids effuse or leak into the peritoneal cavity. [[Biliary Tract Rupture|Rupture of the biliary tract]] results in the leakage of '''bile''' into the abdomen. Initially, this causes few clinical signs but over time, it irritates the visceral and parietal peritoneum and causes them to become inflamed. If the biliary tract is infected at the time of rupture, a septic peritonitis may develop. The parietal peritoneum and abdominal organs are typically stained green by the presence of bile. An image of bile peritonitis in a cat is available [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=3048 here].
Rupture of the urinary tract causes '''urine''' to spill into the abdomen producing a '''uroabdomen'''. As with bile, the urine irritates the peritoneum after 48-72 hours and causes inflammation but it is likely that the animal will show marked clinical signs of stranguria, anuria and depression before this time. If the urinary tract is infected at the time of rupture, a septic peritonitis may develop.
Rupture of the urinary tract causes '''urine''' to spill into the abdomen producing a '''uroabdomen'''. As with bile, the urine irritates the peritoneum after 48-72 hours and causes inflammation but it is likely that the animal will show marked clinical signs of stranguria, anuria and depression before this time. If the urinary tract is infected at the time of rupture, a septic peritonitis may develop.
In small animals with '''[[Pancreatitis - Dog and Cat|pancreatitis]]''', pancreatic enzymes may leak into the abdomen together with discharge from the necrotic peripancreatic fat. This usually results in a local peritonitis in the cranial abdomen and the animal may show signs of pain when this area is palpated.
In small animals with '''[[Pancreatitis|pancreatitis]]''', pancreatic enzymes may leak into the abdomen together with discharge from the necrotic peripancreatic fat. This usually results in a local peritonitis in the cranial abdomen and the animal may show signs of pain when this area is palpated.
[[Chylous Effusion|Chyle]] may cause a mild granulomatous serositis if it accumulates in the abdomen.
[[Chylous Effusion|Chyle]] may cause a mild granulomatous serositis if it accumulates in the abdomen.
The main routes by which bacteria enter the peritoneal cavity are from the gastro-intestinal (GI) tract and from externally. '''Penetrating wounds''' to the abdomen and the introduction of '''foreign bodies''' are likely to introduce bacteria.
The main routes by which bacteria enter the peritoneal cavity are from the gastro-intestinal (GI) tract and from externally. '''Penetrating wounds''' to the abdomen and the introduction of '''foreign bodies''' are likely to introduce bacteria.
GI bacteria may enter the peritoneal cavity after perforation or rupture of the intestine. This may occur due to erosion of the intestinal wall by ulcers or neoplasia or due to rupture after a loop of intestine is strangulated. [[Rectal Perforation|Rectal tears]] of the higher grades in horses may also lead to the introduction of bacteria.
GI bacteria may enter the peritoneal cavity after perforation or rupture of the intestine. This may occur due to erosion of the intestinal wall by ulcers or neoplasia or due to rupture after a loop of intestine is strangulated. Rectal tears of the higher grades in horses may also lead to the introduction of bacteria.
Rupture of other infected tracts (including the urinary tract, reproductive tract and biliary tract) may also cause septic peritonitis.
Rupture of other infected tracts (including the urinary tract, reproductive tract and biliary tract) may also cause septic peritonitis.
====Viral Peritonitis====
====Viral Peritonitis====
[[File:FIP Punktat.jpg|thumb|Image of the protein-rich effusion produced in cats with FIP<br><small>Copyright Kalumet 2006 Wikimedia Commons]]</small>
[[File:FIP Punktat.jpg|thumb|Image of the protein-rich effusion produced in cats with FIP<br><small>Copyright Kalumet 2006 Wikimedia Commons]]</small>
The 'wet' or effusive form of [[Feline Infectious Peritonitis|'''feline infectious peritonitis''']] is caused by pyogranulomatous inflammation of the venules of the omentum and aprietal and visceral peritoneum. This vasculitis results in the effusion of sero-fibrinous fluid with a high protein and immunoglobulin content and tags of fibrin attach to the [[Peritoneal cavity - Anatomy & Physiology|peritoneum]] and abdominal organs.
The 'wet' or effusive form of [[Feline Infectious Peritonitis|'''feline infectious peritonitis''']] is caused by pyogranulomatous inflammation of the venules of the omentum and aprietal and visceral peritoneum. This vasculitis results in the effusion of sero-fibrinous fluid with a high protein and immunoglobulin content and tags of fibrin attach to the [[Peritoneal Cavity - Anatomy & Physiology|peritoneum]] and abdominal organs.
====Parasitic Peritonitis====
====Parasitic Peritonitis====
**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 cavity - Anatomy & Physiology|peritoneal cavity]] and causing vascular permeability, loss of intestinal absorption
**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.
===Horses===
===Horses===
Diffuse acute septic peritonitis (as caused by [[Rectal Perforation|rectal tears]] or GI rupture) is frequently fatal in horses and affected animals are often euthanased when after a diagnosis is made. Septic peritonitis occurs most commonly due to rupture of the strangulated loops of small intestine or rupture of a stomach distended by fluid refluxed from the duodenum. For an image of acute fibrinous peritonitis in a horse, see[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=6111|here].
Diffuse acute septic peritonitis (as caused by rectal tears or GI rupture) is frequently fatal in horses and affected animals are often euthanased when after a diagnosis is made. Septic peritonitis occurs most commonly due to rupture of the strangulated loops of small intestine or rupture of a stomach distended by fluid refluxed from the duodenum. For an image of acute fibrinous peritonitis in a horse, see[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=6111|here].
In foals, purulent or granulomatous peritonitis may be caused by generalised [[Rhodococcus equi|''Rhodococcus equi'']] infection or fibrinous peritonitis by systemic ''[[Actinobacillus equuli]]'' infection.
In foals, purulent or granulomatous peritonitis may be caused by generalised [[Rhodococcus equi|''Rhodococcus equi'']] infection or fibrinous peritonitis by systemic ''[[Actinobacillus equuli]]'' infection.
===Cattle===
===Cattle===
Peritonitis may occur due to traumatic or iatrogenic perforation of an abdominal organ, usually the [[The Reticulum - Anatomy & Physiology|reticulum]] or [[Female Reproductive Tract -The Uterus - Anatomy & Physiology|uterus]]. This produces an acute diffuse fibrinopurulent peritonitis or, in some cases, the inflammation may be confined to a smaller area of the peritoneal cavity by the exuberant formation of fibrous tissue.
Peritonitis may occur due to traumatic or iatrogenic perforation of an abdominal organ, usually the [[Reticulum - Anatomy & Physiology|reticulum]] or [[Uterus - Anatomy & Physiology|uterus]]. This produces an acute diffuse fibrinopurulent peritonitis or, in some cases, the inflammation may be confined to a smaller area of the peritoneal cavity by the exuberant formation of fibrous tissue.
[[Traumatic Reticulitis|Traumatic reticuloperitonitis]] occurs when an ingested foreign body becomes lodged in the reticulum and subsequently perforates this organ. This usually produces a localised peritonitis between the reticulum and diaphragm but, in severe cases and in cows around parturition, generalised inflammation may develop. The foreign body me penetrate cranially through the diaphragm and into the pericardial sac. Potential sequelae include acute haemorrhage due to penetration of the left gastro-epiploic artery and vagal indigestion.
[[Traumatic Reticulitis|Traumatic reticuloperitonitis]] occurs when an ingested foreign body becomes lodged in the reticulum and subsequently perforates this organ. This usually produces a localised peritonitis between the reticulum and diaphragm but, in severe cases and in cows around parturition, generalised inflammation may develop. The foreign body may penetrate cranially through the diaphragm and into the pericardial sac. Potential sequelae include acute haemorrhage due to penetration of the left gastro-epiploic artery and vagal indigestion.
Local chronic peritonitis, abscesses containing usually ''[[Actinomyces pyogenes]]''
Local chronic peritonitis, abscesses containing usually ''[[Actinomyces pyogenes]]''
Acute gelatinous haemorrhagic peritonitis may occur as part of a systemic disease caused by ''[[Bacillus anthracis]]'' ('''Anthrax''')
Acute gelatinous haemorrhagic peritonitis may occur as part of a systemic disease caused by ''[[Bacillus anthracis]]'' ('''Anthrax''')
==References==
{{Learning
The following images are available:
|Vetstream = [https://www.vetstream.com/felis/search?s=peritonitis Peritonitis]
[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=1262 Image of acute fibrinous peritonitis from Cornell Veterinary Medicine]
|flashcards = [[Cytology Q&A 15]]
[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=11598 Image of FIP by Cornell Veterinary Medicine]
}}
== References ==
The following images are available: [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=1262 Image of acute fibrinous peritonitis from Cornell Veterinary Medicine] [http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=11598 Image of FIP by Cornell Veterinary Medicine]
{{unfinished}}
[[Category:To_Do_-_Alimentary]][[Category:To Do - Major]] [[Category:Peritoneal_Diseases_-_Cattle]] [[Category:Donkey]] [[Category:Peritoneal_Diseases_-_Sheep]] [[Category:Alimentary_Diseases_-_Goat]] [[Category:Alimentary_Diseases_-_Pig]] [[Category:Alimentary_Diseases_-_Birds]] [[Category:Peritoneal_Cavity_-_Inflammatory_Pathology]] [[Category:Peritoneal_Cavity_Diseases_-_Horse]]
==Webinars==
<rss max="10" highlight="none">https://www.thewebinarvet.com/gastroenterology-and-nutrition/webinars/feed</rss>