NEWS UPDATE-PERITONITIS

PERITONITIS

Peritonitis is the infection by certain bacteriae leads to inflammation which causes rupture or perforation at the peritoneum.

The peritoneum is a moist tissue around the inside of the stomach wall. The peritoneum lines the abdominal wall. It also forms a number of folds that go inward.

In brief, the peritoneum holds the inside parts of the abdomen such as the stomach, and intestines, and other organs such as the liver and kidneys. By folding in the peritoneum weaves between abdominal organs and giving them a covering membrane. In this way, the peritoneum holds the inside organs of the belly in the proper place.

The peritoneal membrane is supplied with blood vessels and nerves. These vessels can be seen running through the curtain of membrane holding together the intestines.

It is an urgent serious condition that needs immediate attention from a doctor.

Symptoms

 

1. Symptoms include sudden severe belly pain.

Appendicitis is one of the major causes of this problem. When appendicitis develops into a ruptured appendix it is assumed that pus from the ruptured appendix burst from the gut into the peritoneum.

Severe sudden stomach pain that gets worse is the major indication of peritonitis.

2. Some times serious reactions such as dehydration and shock may need urgent attention by doctors.

3.Fever

4.Nausea and Vomiting

5.Diarrhea(a must)

6.Loss of appetite

7.Tachycardia

8.Anal block

9.Swollen belly

If any of these symptoms present then it may be an indication of peritonitis. Swollen belly may also be an indicator of the hepatic disorder.

Dehydration occurs due to loss of fluid through the rupture of the peritoneum and fluid from all over the body moves through this rupture down to the bowel.

If the liver is infected along with the peritoneum that may cause a collection of fluid which may be the reason for swollen belly even if there is no rupture.

Hence liver disease also one of the causes of peritonitis. This is known as Spontaneous Bacterial Peritonitis

Spontaneous peritonitis causes mild to moderate pain because of the absence of perforation or rupture.

The increased fluid in the belly may cause discomfort.

Medical Emergency

If peritonitis is not immediately attended it may lead to sepsis and septic shock. Hence it must be treated as a medical emergency.

Causes

1. Most of the causes are due to infections mostly from other sources.

Sometimes there may be no infection but there must be present some kind of pathological disorder in the peritoneum itself.

A rupture of the gut is often the source of infection. A burst appendix or a perforated ulcer can cause the infection.

2. Peritoneal Dialysis in which fluid is filled into the peritoneum and exchanged can also cause infection from outside the body.

3.Inflammation of the pancreas

4.Crohn's Disease

5.Inflammation of the pouches in the large intestinal wall-Diverticulitis 

6.Injuries that cause trauma to the belly such as gun or knife injuries.

7. Less commonly due to liver disease.

8.Stomach Cancer

Diagnosis

1. The exchanged peritoneal dialysis fluid should be diagnosed for any uncommon change in color.

2.Physical examination of the belly.

3. Check for infections by blood samples

4.X-ray or ultrasound

5.C.T.scan

6.Taking fluid from the belly and testing it.-Paracentesis

Treatments

Patients should be admitted to the hospital and urgently given intravenous injections of any broad-spectrum antibiotics as an emergency phase before the causative organism has been found out by tests.

After the test result came the doctor should start with specific treatments.

If perforations or ruptures are seen surgery should be performed.

This article is prepared on the basis of writing by Markus MacGill and published on Sat 27 Aug 2016.