Secondary peritonitis overview: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary peritonitis is a result of an inflammatory process in the peritoneal cavity secondary to inflammation, perforation, or gangrene of an intra-abdominal or retroperitoneal organ. Surgical intervention is typically required to treat these processes. Antibiotics play an adjunctive role in severe intra-abdominal infection. If left untreated, patients with Secondary peritonitis usually die due to life-threatening Sepsis and Shock. | Secondary peritonitis is the most common cause of peritonitis, seen in 80-90% of patients, as a result of an inflammatory process in the peritoneal cavity secondary to inflammation, perforation, or gangrene of an intra-abdominal or retroperitoneal organ. Surgical intervention is typically required to treat these processes. Antibiotics play an adjunctive role in severe intra-abdominal infection. If left untreated, patients with Secondary peritonitis usually die due to life-threatening Sepsis and Shock. | ||
== Definition == | == Definition == | ||
Revision as of 02:18, 7 February 2017
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Secondary Peritonitis Microchapters |
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Diagnosis |
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Treatment |
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Secondary peritonitis overview On the Web |
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American Roentgen Ray Society Images of Secondary peritonitis overview |
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Directions to Hospitals Treating Spontaneous bacterial peritonitis |
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Risk calculators and risk factors for Secondary peritonitis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Synonyms and keywords:: Surgical peritonitis, Perforation peritonitis, Acute peritonitis, Acute abdomen.
Overview
Secondary peritonitis is the most common cause of peritonitis, seen in 80-90% of patients, as a result of an inflammatory process in the peritoneal cavity secondary to inflammation, perforation, or gangrene of an intra-abdominal or retroperitoneal organ. Surgical intervention is typically required to treat these processes. Antibiotics play an adjunctive role in severe intra-abdominal infection. If left untreated, patients with Secondary peritonitis usually die due to life-threatening Sepsis and Shock.
Definition
Secondary peritonitis is defined as the infection of the peritoneum due to spillage of organisms into the peritoneal cavity resulting from hollow viscus perforation, anastomotic leak, ischemic necrosis, or other injuries of the gastrointestinal tract.[1]
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Secondary peritonitis from other conditions
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT Scan
Ultrasound
Diagnostic Evaluation of Secondary Peritonitis
| Ascitic fluid with PMN ≥250 cells/mm3 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Bile stained ascitic fluid | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ascitic fluid biluribin >6 mg/dl and ascitic fluid/serum bilurin >1 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| IF NO → | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| IF YES "BILIARY PERFORATION" | Fulfilment of atleast 2 of the following diagnostic criteria: ❑ Total protein >1g/dl ❑ Glucose <60 mg/dl ❑ LDH >upper limit of normal | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| IF NO Ascitic PMN < baseline. After 48 hours of therapy with antibiotics | IF YES Free air or extravasation of contrast medium | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| IF YES "SPONTANEOUS BACTERIAL PERITONITIS" | IF NO | IF NO | IF YES "PERFORATION PERITONITIS" | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| "NON-PERFORATIONAL SECONDARY PERITONITIS" | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No evidence for loculated infection | Evidence for loculated infection with U/S or Barium enema etc. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| "SPONTANEOUS BACTERIAL PERITONITIS" ❑ Continue antibiotic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| LAPAROTOMY | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Medical Therapy
Surgery
Prevention
References
- ↑ Calandra T, Cohen J, International Sepsis Forum Definition of Infection in the ICU Consensus Conference (2005) The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 33 (7):1538-48. PMID: 16003060