Description peritonitis

Peritonitis (peritonitis) is a serious inflammatory disease of the peritoneum. (If your doctor diagnoses a disease whose Latin name ending – itis, it is an inflammation). The peritoneum is a thin membrane in the abdominal cavity that lines and also covers the abdominal organs, eg. Liver, stomach, intestines etc. Its function is to protect and support organs of the abdominal cavity.

Peritonitis can be localized on a particular site or may be generalized, in which case the entire abdominal cavity is affected with acute threat to the patient’s life. This whole group of diseases can be divided into two main groups, which are very different treatment. The first group is infectious peritonitis, which is caused by any germs. The second group includes a non-infectious inflammation of the peritoneum, which is a factor causing very different.

infectious peritonitis

As we mentioned, this type of peritonitis caused by germs. Most often it is the bacteria, but lately no exception even mold. A common cause of bacterial peritonitis, perforation of the digestive tract, the subsequent inflammation is caused primarily by its own intestinal bacteria. Such perforations can be caused by various inflammations partial local authorities (e.g. appendicitis, cholecystitis), or other causes – e.g. perforation at the site of a tumor, ulcer. The exception may be no accident that could cause swallowed a sharp object, possibly abdominal trauma (injury), which entered the bacteria into the abdominal cavity from the external environment. Rarely can perforate the wall of the abdominal organ during medical examinations (eg. When colposcopy or gastroscopy).

Another special cause infectious peritonitis is spontaneous bacterial peritonitis. In this case, the complicating diseases of the liver with the fluid in the abdominal cavity. The mechanism of this type of disease is very complex. For simplicity, suffice it to say that the bacteria enter through the intact intestinal wall into the abdominal cavity and cause inflammation there.

Rarely can this disease as a complication of peritoneal dialysis or inflammation can spread from another part of the body = secondary peritonitis. Examples include abdominal tuberculosis, the initial deposit was in the lungs.

Non-infectious peritonitis

This type of inflammation is most frequently caused by irritation of the peritoneum body fluids.Often it is an irritation of the gastric juice, bile, urine, pancreatic or digestive juices. These fluid into the abdominal cavity get back perforation of the competent authority, but are noninfectious.Unfortunately, very often within 48 hours infected with bacteria and inflammation becomes infectious peritonitis, it is very important early intervention physicians.

Much rarer peritonitis are included autoimmune inflammations (e.g. systemic lupus erythematosus, etc.).

Risk factors for peritonitis

As is apparent from the introduction, the peritonitis is actually any complication of the underlying disease. May arise as a complication of perforation of the wall of the digestive tract, due to the primary disease. This may be intestinal obstruction (ileus), inflammation of various abdominal organs (appendicitis, pancreas, gall bladder, etc.), tumors in this area or ulcer disease. Another risk factor is a liver disease with portal hypertension formation and accumulation of fluid in the abdomen (ascites) and abdominal injuries. Very rarely, may pose a risk of inflammation in other areas of the human body or an autoimmune disease (a disease resulting from an excessive immune function of man).

prevention of peritonitis

Basic prevention is to avoid the primary disease, which are named in the risk factors. In the case of liver disease with portal hypertension is vital to avoid alcohol consumption. The maximum daily dose is 1-2 dl of wine or a small beer for women, 2-3 dl of wine or beer for men. The same applies to the inflammation of the pancreas, which in addition to alcohol and must avoid excessively fatty foods. In the case of ulcers of the stomach or duodenum (the first part of the small intestine) is important to reduce re-alcohol, coffee consumption and type of painkiller aspirin, Ibalgin etc. preventing inflammation of the gallbladder is sufficient fluid intake and a diet low in fat and cholesterol. If you already have all these illnesses appear most importantly preventing their timely and correct treatment.

For another group of prevention of causes is to avoid injuries of the abdominal cavity.

Signs and symptoms of peritonitis

The basic symptoms include loss of appetite and nausea after a while, followed by abdominal pain.Pain starts as dull, later worsens sustained and cruel, where even a gentle touch a sick stomach will cause further deterioration in pain. Further patient vomits, may have chills, fever (especially above 38 degrees, or even more). For peritonitis is typical defensive download abdominal muscles, which can detect when palpation. The whole abdomen is hard and impossible to squeeze, due to contraction of muscles and great pain.

Systemic symptoms include rapid heart rate (tachycardia), often also pallor and sweating, especially if the patient gets into shock. Listening can detect the absence of intestinal peristalsis (paralytic ileus), whose expression is more vomiting and nausea (feeling sick). Furthermore, the patient feels thirsty and stopped to urinate and do not go on the bench.

In conclusion we can summarize that peritonitis is a typical example of an acute abdomen.

diagnosis of peritonitis

Diagnosis is mainly based on signs and symptoms (see above). Furthermore, doing blood tests that can detect inflammatory parameters and disturbances in ion equilibrium. A very important diagnostic method is X-ray of the abdomen, which detects the resulting intestinal obstruction (ileus) or perforation of the stomach. If the patient has fluid in the abdominal cavity (ascites), we can make the puncture, and to send a sample of the fluid on the microbiological examination, which will reveal the pathogen. Still performs radiography the heart and lungs, as a normal examination. On the diagnosis and treatment are involved in internal and surgical departments.

If you are still in doubt, you can perform abdominal ultrasound, CT or MRI. In the case that this is a very acute peritonitis with rapidly deteriorating patient specific examination do and the patient is sent to the operating room.

treatment of peritonitis

If infectious peritonitis, launching a fierce intravenous administration of antibiotics and infusion fluids with ions. First administered antibiotics as the most common cause peritonitis, after results of microbiological tests shall be made against quite specific bacteria. In the case of inflammation caused by fungi, they are the treatment of choice antifungals. If peritonitis caused by intraperitoneal dialysis and the like, they give antibiotics directly into the abdominal cavity. If the inflammation in time nezaléčí or necessary to “fix” the perforation wall of the digestive tract and the like, is required surgical treatment. The surgeon cleans the abdominal cavity, applied here to antibiotics or remove necrotic part of the bowel or other organ.

It is important that the patient with peritonitis placed on monitored bed and were monitored his vital signs.

If the disease is properly treated, mortality is below the 10% mortality in elderly unfortunately rises to 40%. If untreated, it is almost always fatal.

How can I help treat

Peritonitis is such a serious disease, it is necessary to quickly transport the patient to the doctor. It is unacceptable to attempt some home treatment.

complications peritonitis

Very substantial complication of peritonitis sepsis (blood poisoning), when bacteria get from the initial site of infection into the bloodstream and spreads throughout the body. If the treatment is ineffective, develops septic shock when massive flooding organism bacteria causes a reaction of our immune system which washes a large amount of substances (cytokines and other). Cytokines and other substances will cause a significant drop in blood pressure and symptoms such as pallor, sweating and rapid heartbeat. In this condition, the patient should be placed on the intensive care unit, with the support of vital functions, because it is acutely life-threatening.

Another complication is abdominal abscess. It is a border inflammation that persists even after zaléčení peritonitis and almost impossible to destroy with antibiotics. It’s important to puncture and drainage under ultrasound guidance or a surgical removal.

Other names: Peritonitis, Peritonitis

Share your experience: