Peritonitis Lecture Notes

Introduction to Peritonitis

• Definition: Inflammation of the peritoneum.
• Peritoneal Cavity: Includes all abdominal organs (digestive and genito-urinary).

Causes of Peritonitis

• Localized or Systemic Causes
  • Systemic infections or inflammation can lead to sepsis.
  • GI (gastrointestinal) or GU (genito-urinary) infections.
  • Cirrhosis with ascites.
  • Leakage of ascitic fluid causing third spacing.
  • Abdominal conditions like appendicitis, diverticulitis, pancreatitis.
  • Abdominal trauma (e.g., car accident leading to bladder rupture).
  • Risk factors: intestinal perforation, inflammatory bowel diseases (Crohn's, ulcerative colitis), peritoneal dialysis complications, post-op leaks.

Signs and Symptoms

• Severe Abdominal Pain: A hallmark sign.
• Rebound Tenderness: Pain when pressure is released on the abdomen.
• Abdominal Distension: Due to fluid and inflammation.
• Systemic Signs: Fever, shock, hypotension, tachycardia, increased respiratory rate.
• Digestive Symptoms: Nausea, vomiting, decreased bowel sounds.

Complications

• Hypovolemic Shock: Due to fluid loss from the vascular system.
• Sepsis: Systemic infection.
• Abscess Formation
• Paralytic Ileus: Intestine ceases functioning.
• ARDS: Acute respiratory distress syndrome.
• Mortality Risk: Potentially life-threatening.

Diagnostic Tests

• Blood Tests: CBC and CMP to monitor fluids and electrolytes.
• Blood Cultures: Important for detecting systemic infection.
• Peritoneal Aspiration: To culture fluid and identify infection.
• Imaging: X-rays, ultrasounds, CT scans to assess peritonitis' extent and complications.

Treatment

• Antibiotics: Based on culture and sensitivity reports.
• NG Tube: To rest the digestive system, NPO (nothing by mouth).
• Fluid and Electrolyte Management: Prevent losses of sodium, potassium, and proteins.
• Anti-emetics: For nausea and vomiting.
• Surgery: If necessary, to fix leaks or complications.
• Pain Management: Essential due to severe pain.

Nursing Care

• Vital Signs Monitoring: Critical for early detection of complications.
• Abdominal Assessment: Monitor for pain, tenderness, distension, and bowel sounds.
• Fluids and Electrolytes Management: Administer IV fluids as needed.
• TPN Consideration: Total parenteral nutrition for prolonged NPO status.
• IV Antibiotics Administration: As prescribed.

Conclusion

• Follow-up Videos: For more information on related GI disorders, refer to the GI playlist.

Note: This summary provides key points from the lecture on peritonitis, focusing on causes, symptoms, complications, diagnostics, treatment, and nursing care.