Surgery diseases >>>> What is peritonitis?

What is peritonitis?

An infectious or aseptic (without the participation of microbes) inflammatory process in the peritoneal region is called peritonitis. The sheets of the peritoneum, formed by the connective tissue, line the abdominal cavity from the inside, separating it from the muscle tissue, and the internal organs from each other. Infectious agents or chemicals, getting into the abdominal cavity, cause inflammatory processes that change the general condition of the body to an extremely severe one.

The causes of peritonitis:

Generalized infection in the body that travels with the bloodstream and / or lymph flow;
Infection that enters the peritoneal cavity with a ruptured appendix, perforation of the walls of the stomach or intestines with ulcers or intestinal obstruction, trauma to the stomach or intestines by foreign bodies, chemical reagents;
Infection of the peritoneal cavity as a result of tissue decay with hernia, tumors;
Abdominal trauma with penetrating wounds and / or hematomas;
Ascites;
Infection from the genitourinary system.

The signs of peritonitis differ depending on the stage of the inflammatory process and the disease that caused the peritonitis:

At the first stage, pain occurs, which is characterized by the sensation of a dagger strike. The pain can be localized in the area of the affected organ (appendix, stomach, intestines) or spread to the entire abdominal region (diffuse). Sometimes the intensity of the pain decreases, resulting in a false sense of well-being. The pain resumes after two to three hours. The temperature may rise. The patient's skin turns pale, acquiring a grayish, bluish or earthy hue. Sweat appears on the surface of the skin. The patient assumes a forced posture that most relieves suffering (lying on his side, on his back with bent legs). Deep breathing and coughing will increase the pain.

The muscles of the abdominal region are tense and when feeling the abdomen, a sign typical of peritonitis is observed (Shchetkin-Blumberg symptom): with pressure on the abdomen and abrupt withdrawal of the hand, the pain intensifies. The patient may feel the urge to vomit, nausea, thirst.

At the second stage, signs of intoxication of the body appear:

The temperature rises to 40-42 in Celsius ,
The pain smolders weakly or disappears altogether,
The muscles in the abdominal area relax,
There is a cold snap of the limbs,
The thirst increases,
Painful vomiting begins (dark brown color of vomit),
The pulse quickens,
Breathing becomes intermittent.

At the third stage, the terminal stage of peritonitis develops (on the third day): facial features sharpen, the cheeks sink, the skin is cyanotic, there is no pain. Respiratory function is impaired, the pulse is not felt. In this state, the patient's life is supported by the hardware support of life. Two or three days later, death occurs.

Diagnosis of peritonitis should be carried out as early as possible, with suspicious signs typical of it. It is early diagnosis and timely treatment that make it possible to avoid death.

Treatment of peritonitis involves surgical intervention - an emergency operation, as a result of which the source of inflammation is found, tumors and necrotic tissue are removed, internal bleeding is stopped, the peritoneal cavity is washed with antiseptic solutions and treated with proteolytic enzymes. To suppress the infection, antibiotic therapy, immunostimulants are prescribed. To remove toxic substances, infusion therapy is performed.