Treating Peritonitis: A Health Guide

There is a layer of membrane in the abdominal cavity of the normal human body, covering the inner layer of the abdominal wall and the surface of the abdominal organs. This layer of membrane is called the peritoneum. Peritonitis is an inflammation caused by bacterial infection, chemical irritation or injury, etc. It is a common and serious disease in surgery.
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In this article, we’ll take a closer look at this disease, what causes it, and what to expect before, during, and after treatment.

Symptoms of peritonitis

Abdominal pain: is the most important manifestation. It is usually very severe and unbearable, like a knife cutting, and the pain is even worse when turning the body. Usually, the patient is unwilling to change body positions and is persistent. Generally, the location of the pain first appears at the location of the original disease, and as the inflammation spreads, it will spread throughout the abdomen. all feel pain;

Feelling sick and vomit;

Body temperature and the pulse often change: body temperature rises and the pulse becomes faster;

There is pain when pressing the abdomen, the abdominal muscles are hard, and the pain is more obvious (tenderness, muscle tension, rebound tenderness) after the fingers are removed from pressing the abdomen.

Causes of peritonitis

Primary peritonitis: What we call spontaneous peritonitis (refers to peritoneal inflammation caused by non-abdominal organ damage), that is, bacteria infect the peritoneum through the blood, female reproductive tract, urinary tract, and intestinal wall (transmural bacteria). The main pathogenic bacteria are Escherichia coli, Diplococcus pneumoniae, and hemolytic Streptococcus.

Secondary peritonitis: is the most common peritonitis. Abdominal wall or visceral rupture caused by perforation or trauma of intra-abdominal organs, spread of inflammation of intra-abdominal organs, abdominal contamination during abdominal surgery, severe infection of the anterior and posterior abdominal walls, etc. Most of the pathogenic bacteria are Escherichia coli, Anaerobacteria, Streptococcus, Proteus, etc.

Conservative treatment of peritonitis

If the condition is mild or lasts for more than 24 hours, if there are mild abdominal pain or signs of peritonitis, or if there are severe heart, lung and other organ diseases that cannot tolerate surgery, conservative treatment can be adopted without surgery. These include:

  • Maintain a semi-recumbent position;
  • Insert a nasogastric tube to drain gastric juice, decompress the gastrointestinal tract, and reduce pressure on the abdominal digestive tract;
  • IV fluids to replace energy/calories, lost fluids, and electrolytes;
  • Treat with antibiotics, such as clindamycin;
  • After the diagnosis is clear and the treatment plan is determined, sedatives (valium) or analgesics can be used as appropriate after surgery or when mental symptoms occur due to pain.

Peritonitis requiring surgical treatment

The vast majority of secondary peritonitis requires surgical treatment. Situations requiring surgery include the following:

  • After 6 to 8 hours of non-surgical treatment (generally no more than 12 hours), the symptoms and signs of peritonitis are not relieved but worsened.
  • Severe primary diseases in the abdominal cavity, such as gastrointestinal perforation or gallbladder gangrene, strangulated intestinal obstruction, damage and rupture of intra-abdominal organs, and peritonitis caused by early anastomotic leakage after gastrointestinal surgery.
  • Intra-abdominal inflammation is severe, there is a large amount of fluid accumulation, severe intestinal paralysis, or poisoning symptoms, especially those with shock.
  • If the cause of peritonitis is unclear and tends to worsen, laparotomy is required to find the cause and treat it.
  • Surgical treatment includes these three key points: treatment of the primary lesion, cleaning of the abdominal cavity, and adequate drainage.

Prevention of peritonitis

Preventing peritonitis requires preventing the primary disease (for example: perforation caused by gastroduodenal ulcer, acute appendicitis, acute cholecystitis, etc.). When there is a history of intra-abdominal organ disease, treat it as soon as possible to avoid perforation or rupture that may cause dissemination.

Conclusion

Once severe and unbearable abdominal pain occurs, you should seek medical treatment promptly. Mild cases are treated conservatively, while severe cases require surgery. Pay attention to the prevention of primary diseases, early medical treatment and early treatment.