Peritonitis Anatomy and Physiology



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Peritonitis


Anatomy and Physiology

  • The peritoneum is a thing, double layer of serous membrane in the abdominal cavity

  • The area of the peritoneum is around

  • 2 square meters



Anatomy and Physiology

  • All organs are divided on 3 groups:

  • Intraperitoneal

  • Mesoperitoneal

  • Extraperitoneal



Anatomy and Physiology

  • Peritoneum tissue

  • is a typical connective tissue;

  • is covered by polygonal mesothelium;

  • has very good plastic peculiarities;

  • has a very good blood supply.



Anatomy and Physiology

  • The parietal peritoneum is innervated by the sensitive somatic nerves

  • The pain as a result of the parietal peritoneum irritation is localized (somatic pain)

  • The pelvic peritoneum has no somatic innervations



Anatomy and Physiology

  • The visceral peritoneum has vegetative (parasympathic and sympathic) innervations

  • The pain as a result of the visceral peritoneum irritation is not localized



Definition

  • Peritonitis is an inflammation of the peritoneum



Classification

  • Acute peritonitis

  • Subacute peritonitis

  • Chronic peritonitis



Classification

  • Primary peritonitis

  • Secondary peritonitis

  • Meconium peritonitis



Classification

  • I Bacterial peritonitis

  • a) staphylococcus

  • b) streptococcus

  • c) proteus

  • d) enterococcus

  • II Sterile peritonitis

  • a) caused by bile

  • b) caused by pancreatic enzymes



Classification

  • 1. Serous peritonitis

  • 2. Fibrinous peritonitis

  • 3. Fibrinopurulent peritonitis

  • 4. Purulent peritonitis

  • 5. Hemorrhagic peritonitis

  • 7. Putrid peritonitis



Clinical Classification

  • Local peritonitis

  • a) encapsulated (abscess)

  • b) non-encapsulated

  • II. General peritonitis

  • a) Diffuse

  • b) Total



Clinical Classification

  • Stages of Peritonitis

  • Initial (reactive) stage (up to 24 hours)

  • Toxic stage (24- 72 hours)

  • Terminal stage (after 72 hours)



Clinical features

  • Abdominal pain

  • Tenderness to palpation

  • Increased abdominal wall rigidity

  • Anorexia and nausea

  • Vomiting

  • Fever

  • Tachycardia



Lab Analyses

  • Leukocytosis or leukocytopenia

  • Dehydration and acidosis

  • Peritoneal fluid analysis



Antibiotic therapy

  • Antibiotic therapy

  • Correction of existing serum electrolytes disturbances

  • Correction of coagulation abnormalities

  • Surgery



Surgery

  • To eliminate the source of contamination

  • To reduce the bacterial contamination

  • To prevent further complications and sepsis



Thank you





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