Peritonitis

Peritonitis

Acute inflammation of the visceral/parietal peritoneum and endothelial lining of the abdominal cavity or peritoneum.

Common Causes of Bacterial Peritonitis

Appendicitis Perforations associated with PUD Diveriticulitis Gangrene gallbladder Bowel Obstruction

Other causes of Peritonitis

Ascending infection of the reproductive tract or septic abortion Perforated tumors Ulcerative colitis Foreign bodies Leakage or contaminated during surgery Skin infection with clients undergoing peritoneal dialysis

Complications of Peritonitis

Bowel obstruction- from inflammation Sepsis- from bacterial invasion Shock- from sepsis and hypovolemia

Peritonitis, Etiology

Caused by contamination from bacteria or chemicals

Surgical Management of Peritonitis: Focus on

Controlling the contamination Removal of foreign material Removal of foreign material Draining collected fluid Exploratory laparotomy --Removal/repair of inflamed or perforated organ --Irrigation of the peritoneal cavity with antibiotic solution

Diagnostic Assessment of peritonitis

Elevated WBC > 20,000 Low H/H Altered Electrolytes- K, Na, Cl- Abdominal X-ray and US Abdominal CT Peritoneal aspiration and culture

Chemical Causes of Peritonitis

Leakage of Bile Pancreatic Enzymes Gastric Acid

Non Surgical Management of Peritonitis

Monitor IVF and administer broad spectrum antibiotics Daily weight and I&O Monitor NG tube- placed properly and draining properly NPO- rest bowel Oxygen administration Pain Management

Peritonitis Pathophysiology

Peritoneal cavity normally contains 50 ml of sterile fluid. It serves to prevent friction of abdominal cavity during peristalsis. When the peritoneal cavity is contaminated by bacteria, inflammation occurs and the area walls off to fight the infection. If the walling off process fails, inflammation spreads and contamination becomes massive in the peritoneal cavity.

SxS of Peritonitis

Rigid, BOARD-LIKE Abdomen "Classic" Abdominal pain with rebound tenderness general not specific to one area Distended abdomen N/V/ and anorexia Decreased BS and BM High fever Tachycardia Dehydration with poor skin turgor Decreased urine output HICCUPS- Abdominal cavity irratated when irratates diaphram Possible compromised respiratory status

Post OP Care

See Notes