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Peritonitis

Peritonitis. Anatomy and Physiology. The peritoneum is a thing, double layer of serous membrane in the abdominal cavity The area of the peritoneum is around 2 square meters. Anatomy and Physiology. All organs are divided on 3 groups: Intraperitoneal Mesoperitoneal Extraperitoneal.

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Peritonitis

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  1. Peritonitis

  2. Anatomy and Physiology The peritoneum is a thing, double layer of serous membrane in the abdominal cavity The area of the peritoneum is around 2 square meters

  3. Anatomy and Physiology All organs are divided on 3 groups: • Intraperitoneal • Mesoperitoneal • Extraperitoneal

  4. Anatomy and Physiology Peritoneum tissue is a typical connective tissue; is covered by polygonal mesothelium; has very good plastic peculiarities; has a very good blood supply.

  5. Anatomy and Physiology The parietal peritoneum is innervated by the sensitive somatic nerves The pain as a result of the parietal peritoneum irritation is localized (somatic pain) The pelvic peritoneum has no somatic innervations

  6. Anatomy and Physiology The visceral peritoneum has vegetative (parasympathic and sympathic) innervations The pain as a result of the visceral peritoneum irritation is not localized

  7. Definition Peritonitis is an inflammation of the peritoneum

  8. Classification • Acute peritonitis • Subacute peritonitis • Chronic peritonitis

  9. Classification • Primary peritonitis • Secondary peritonitis • Meconium peritonitis

  10. Classification I Bacterial peritonitis a) staphylococcus b) streptococcus c) proteus d) enterococcus II Sterile peritonitis a) caused by bile b) caused by pancreatic enzymes

  11. Classification 1. Serous peritonitis 2. Fibrinous peritonitis 3. Fibrinopurulent peritonitis 4. Purulent peritonitis 5. Hemorrhagic peritonitis 7. Putrid peritonitis

  12. Clinical Classification • Local peritonitis a) encapsulated (abscess) b) non-encapsulated II. General peritonitis a) Diffuse b) Total

  13. Clinical Classification Stages of Peritonitis • Initial (reactive) stage (up to 24 hours) • Toxic stage (24- 72 hours) • Terminal stage (after 72 hours)

  14. Clinical features • Abdominal pain • Tenderness to palpation • Increased abdominal wall rigidity • Anorexia and nausea • Vomiting • Fever • Tachycardia

  15. Lab Analyses • Leukocytosis or leukocytopenia • Dehydration and acidosis • Peritoneal fluid analysis

  16. Treatment Antibiotic therapy Correction of existing serum electrolytes disturbances Correction of coagulation abnormalities Surgery

  17. Surgery • To eliminate the source of contamination • To reduce the bacterial contamination • To prevent further complications and sepsis

  18. Thank you

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