Peritonitis
Peritonitis is a severe inflammation of the peritoneum, which carries a deadly threat to human life. Peritonitis is a condition in which emergency medical care plays a key role.
CAUSES OF THE DISEASE
Inflammation of the peritoneum is most often caused by chemical irritants entering it – as a rule, it is the contents of the gastrointestinal tract that penetrates into the peritoneum when these organs are damaged. Another cause of peritonitis can be infection, as well as any inflammatory disease of the abdominal cavity affecting the peritoneum:
Pancreatitis,
Cholecystitis,
Appendicitis with the opening of ulcers,
Stomach ulcer with perforation,
Lymphadenitis,
Intestinal obstruction.
kinds
It is customary to distinguish between local and general peritonitis. With a local type of disease, a separate area of the peritoneum becomes inflamed, with a general one, the entire peritoneum becomes inflamed.
Abdominal abscess is also isolated as a type of inflammation that can lead to general or local peritonitis.
SIGNS AND SYMPTOMS
The very first symptom of peritonitis is abdominal pain. From external signs, it is possible to note graying of the skin, pallor of the face, sunken eyes.
Abdominal muscles with peritonitis are tense, and this is clearly noticeable regardless of the stage of the disease.
From the first hours of the development of peritonitis, nausea and vomiting occur. At first, their nature is exclusively reflex, however, as the pathology develops, intestinal and stomach paralysis begins to progress, and vomiting becomes a consequence of intestinal obstruction. With peritonitis, unlike poisoning, vomiting does not contribute to the relief of the condition.
Typical for peritonitis is the Blumberg-Shchetkin symptom – increased pain when probing the anterior abdominal wall.
diagnostics
Peritonitis is diagnosed using the following methods:
Analysis of patient complaints and collection of anamnesis, including collection of information about existing diseases of the abdominal cavity,
General examination – most often the patient stays in the “embryo pose”, his legs are bent and pulled up to the stomach, when the position changes, the pain increases.
Specific symptoms, including the already mentioned Blumberg-Shchetkin symptom.
Body temperature measurement – elevated temperature indicates a progressive pathology.
Pressure measurement – low blood pressure indicates that the patient’s condition is deteriorating.
Laboratory methods – general blood and urine analysis, urine and blood culture, biochemical blood tests, ionograms.
Ultrasound of the abdominal cavity or other instrumental techniques – computer or magnetic resonance imaging of the abdominal cavity (make it possible to identify pathological changes in the size of the peritoneum).
ECG.
Detection of the focus of peritonitis by means of an overview radiography of the abdominal cavity,
Laparoscopy of the abdominal cavity and pelvis or laparocentesis (puncture) of the abdominal wall with subsequent analysis of the resulting fluid.
PRINCIPLES OF TREATMENT
Treatment of peritonitis involves the removal of an inflammatory focus and the use of broad-spectrum antibiotics. The removal of the focus of inflammation consists in the prompt elimination of the focus and the subsequent establishment of drainage (outflow) of the infiltrate. For this purpose, flexible drainage tubes are used, which are inserted into the abdominal cavity.
Antibiotics in the treatment of peritonitis are used parenterally, that is, administered through peripheral veins.
With peritonitis, the prognosis is 100% dependent on the efficiency of medical care. In the absence of such a fatal outcome occurs after 4-5 days.
PREVENTION
Prevention of peritonitis implies timely treatment of all gastrointestinal diseases and careful health control, periodic visits to the doctor, passing preventive examinations.
