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Peritonitis

From Mediwikis

Acute peritonitis can be localised or generalised.
Localised acute peritonitis is secondary to all acute inflammatory conditions of the gastrointestinal tract (e.g. - acute appendicitis, acute cholecystitis). The treatment is for the underlying disease.
Generalised acute peritonitis is a serious condition resulting from:

  • Infection (e.g. - perforated appendix)
  • Chemical irritation due to leakage of intestinal contents (e.g. - perforated ulcer)
    • Superadded infection gradually occurs (e.g. - E. coli most common)

Symptoms & Signs

Localised (Inflammatory)

  • Less rapid onset
  • Initial features are of underlying disease

Generalised (Infection/Chemical)

  • Rapid onset
    • Acute severe abdominal pain
  • General collapse
  • Shock
  • Lucid period followed by generalised toxaemia

Investigations

  • Chest X-ray - pneumoperitoneum
  • Serum amylase - acute pancreatitis
  • Ultrasound and/or CT

Treatment

  • Surgery
    • Peritoneal lavage of abdominal cavity
    • Specific treatment of underlying condition