Peritonitis: Difference between revisions
Amyamamoto (talk | contribs) (Created page with "==Background== ==Clinical Features== ==Differential Diagnosis== ==Workup== ==Management== ==Disposition== ==See Also== ==External Links== ==Sources== <references/>") |
Amyamamoto (talk | contribs) (creation of note) |
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==Background== | ==Background== | ||
* Inflammation of serosal membrane lining abdominal cavity and intraabdominal organ | |||
* Infectious or sterile (mechanical, chemical) | |||
* Primary: Hematogenous, Spontaneous bacterial peritonitis (SBP) | |||
* Secondary: Perforation or trauma, most common | |||
* Tertiary: Persistent/recurrent infection | |||
==Clinical Features== | ==Clinical Features== | ||
* Abdominal pain | |||
* Abdominal distension | |||
* Anorexia and nausea | |||
* Spontaneous Bacterial Peritonitis | |||
** Fever and chills | |||
* Abdominal pain or discomfort | |||
* Worsening or unexplained encephalopathy | |||
* Diarrhea | |||
* Ascites | |||
* Worsening or new-onset renal failure | |||
* Ileus | |||
* Abdominal wall rigidity, abdominal wall tenderness | |||
* Guarding or rebound | |||
* Sepsis | |||
* Signs of liver faliure | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Perforation | |||
* Chronic peritoneal dialysis | |||
* Neoplasm | |||
* Pyelonephritis | |||
* Empyema | |||
* Rectus hematoma | |||
* Intestinal incarceration, hernia | |||
* Appendicitis | |||
* Mesenteric ischemia | |||
* Abdominal aneurysm | |||
==Workup== | ==Workup== | ||
* Clinical diagnosis | |||
* CBC (leukocytosis), chem, coags, albumin | |||
* Other test: LFT, lipase, UA, Stool sample | |||
* Abdominal Xray (supine, upright, lateral decubitus)- free air? | |||
* US, CT a/p | |||
* Diagnostic paracentesis to r/o SBP: PMN ≥ 250 cells/mm³ | |||
==Management== | ==Management== | ||
* Fluid resuscitation | |||
* Systemic antibiotics | |||
* Surgical consult | |||
* IR consult: Abscess drainage | |||
==See Also== | ==See Also== | ||
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==Sources== | ==Sources== | ||
<references/> | <references/> | ||
Daley BJ, et al. (2014, Sep 25). Peritonitis and Abdominal Sepsis. eMedicine. Retrieved 12/25/2014 from http://emedicine.medscape.com/article/180234-overview | |||
Revision as of 06:23, 26 December 2014
Background
- Inflammation of serosal membrane lining abdominal cavity and intraabdominal organ
- Infectious or sterile (mechanical, chemical)
- Primary: Hematogenous, Spontaneous bacterial peritonitis (SBP)
- Secondary: Perforation or trauma, most common
- Tertiary: Persistent/recurrent infection
Clinical Features
- Abdominal pain
- Abdominal distension
- Anorexia and nausea
- Spontaneous Bacterial Peritonitis
- Fever and chills
- Abdominal pain or discomfort
- Worsening or unexplained encephalopathy
- Diarrhea
- Ascites
- Worsening or new-onset renal failure
- Ileus
- Abdominal wall rigidity, abdominal wall tenderness
- Guarding or rebound
- Sepsis
- Signs of liver faliure
Differential Diagnosis
- Perforation
- Chronic peritoneal dialysis
- Neoplasm
- Pyelonephritis
- Empyema
- Rectus hematoma
- Intestinal incarceration, hernia
- Appendicitis
- Mesenteric ischemia
- Abdominal aneurysm
Workup
- Clinical diagnosis
- CBC (leukocytosis), chem, coags, albumin
- Other test: LFT, lipase, UA, Stool sample
- Abdominal Xray (supine, upright, lateral decubitus)- free air?
- US, CT a/p
- Diagnostic paracentesis to r/o SBP: PMN ≥ 250 cells/mm³
Management
- Fluid resuscitation
- Systemic antibiotics
- Surgical consult
- IR consult: Abscess drainage
See Also
External Links
Sources
Daley BJ, et al. (2014, Sep 25). Peritonitis and Abdominal Sepsis. eMedicine. Retrieved 12/25/2014 from http://emedicine.medscape.com/article/180234-overview