Peritonitis

Definition:

Peritonitis is defined as local or generalized inflammation of the peritoneum, the membrane lining the abdomen that covers the viscera.

Classification of the peritonitis:

  1. Primary Peritonitis
  2. Secondary Peritonitis
  3. Acute Peritonitis
  4. Chronic Peritonitis
  5. Septic Peritonitis
  6. Aseptic Peritonitis

Etiology:

Primary Peritonitis:

  1. Bacteria Secondary Peritonitis
  2. Trauma
  3. Chemical irritants
  4. Risk factors, which may cause Peritonitis: o Appendicitis

o Perforated Peptic Ulcer

o Diverticulitis (Small herniation of mucosal lining of GI Tract) o Pelvic inflammation

o UTI

o Bowel obstruction

o Surgical complication o Pancreatitis

Clinical features:

  1. Abdominal pain (typical sign)
  2. Tenderness in abdomen (Universal sign)
  3. Muscular rigidity
  4. Spasm (Major sign)
  5. Abdominal distension
  6. Ascites
  7. Tachycardia
  8. Tachyponea
  9. Nausea
  10. Vomiting

Complications:

  1. Hypo-volumic shock
  2. Septicemia
  3. Intra-abdominal abscess
  4. Paralytic ileus
  5. Organ failure

Investigation:

  1. Serum electrolyte
  2. Abdominal X-ray
  3. Culture of fluid
  4. CT scan
  5. Ultrasound
  6. Peritoscopy
  7. Serum amylase
  8. CBC

Medical Management:

  1. Antibiotic
  2. Analgesic
  3. IV fluid administration
  4. NG suction

Surgical Management:

  1. Paracenthesis

Nursing Management:

  • Blood pressure monitoring. The patient’s blood pressure is monitored by arterial line if shock is present.
  • Medications. Administration of analgesic and anti emetics can be done as prescribed.
  • Pain management. Analgesics and positioning could help in decreasing pain.
  • I&O monitoring. Accurate recording of all intake and output could help in the assessment of fluid replacement.
  • IV fluids. The nurse administers and closely monitors IV fluids.
  • Drainage monitoring. The nurse must monitor and record the character of the drainage postoperatively.

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