Acute peritonitis: What you need to know
1. Acute peritonitis
Infection of the peritoneum is often severe because the patient has easy access to the existing pathogens and easily spreads to the entire peritoneal cavity. This is a serious and urgent condition that requires immediate treatment.
2. Why is it dangerous?
Severe disease is also due to the ease of spreading throughout the abdomen by peristalsis (colic contractions push the dirt into the abdomen). Therefore, when peritonitis is suspected, it is necessary to diagnose it early and treat it properly and promptly in order to minimize mortality.
3. Causes of peritonitis
The cause of peritonitis can be bacterial or chemical. Bacterial peritonitis is caused by bacteria entering the abdominal cavity by a blood vessel, either by spread from an infection in the abdominal cavity or by perforation of a hollow viscera (intestine, stomach, bladder, etc.) ) fluid and dirt from those organs carry bacteria into the peritoneum causing inflammation. Bacteria can be tuberculosis bacteria (due to peritoneal tuberculosis), intestinal bacteria such as: E.coli, Proteus, Klebsiella, blue pus bacilli, anaerobic bacteria (C. difficil), if perforated hollow viscera (C. difficil) stomach, intestines, bladder, etc.).
4. Symptoms of acute peritonitis
Necessary tests such as complete blood count (high white blood cell count and neutrophil count), erythrocyte sedimentation rate, elevated blood urea, urinalysis, abdominal ultrasound, X-ray- Abdominal radiograph...
Consequences of peritonitis, if severe, if not detected early and treated properly, in time can be fatal, if cured, treated aggressively, later may cause intestinal adhesions, Intestinal obstruction is complex. Therefore, after being cured and discharged from the hospital, patients should always pay attention if there are signs of abdominal pain, constipation, defecation, nausea, vomiting, they must urgently go to the hospital immediately.
5. Diagnosis and Treatment
Peptic ulcer disease. Renal colic. Liver writhing.
Diagnosis of the cause should be based on:
History. The nature of pain and the initial location of pain ... It is necessary to pay attention to common clinical causes first (acute appendicitis rupture, perforation of peptic ulcer, biliary obstruction due to stones ...). 5.2 Treatment The principle is that surgical treatment must be combined with active surgical resuscitation.
5.2.1 Surgical resuscitation: Fluids, electrolytes to rehydrate, electrolytes. Adjust acid-base balance (Natribicarbonate). Strong, broad-spectrum antibiotics, preferably by antibiogram. Ensure respiration, cool down... 5.2.2 Surgical treatment: The principle of surgical treatment is surgery as soon as possible on the basis of active resuscitation. There are cases where both resuscitation and surgery are required.
Solve the cause: Cut the appendix, stitch the perforation .... Clean the abdominal cavity, pay attention to the low areas, the pits. Effective drainage (location, size, ... of the drain, early withdrawal, no adhesions, infection). 5.2.3 Some notes: Anesthesia: Endotracheal anesthesia. Incision: into the direct line or the middle white line above and below the navel. Leave the skin open, when the abdominal wall is closed. Acute peritonitis is a dangerous disease, leaving severe sequelae and having a high risk of death. Therefore, if you see any unusual symptoms, you should immediately seek medical attention.
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