Peritonitis

Peritonitis

Peritonitis is an inflammation of the peritoneum, a membrane that protects the organs inside your abdomen and lines your inner abdominal wall. Peritonitis is typically brought on by a bacterial or fungal infection. The peritoneum, a thin layer that lines the interior of the belly and covers the majority of the abdominal organs, becomes inflamed when it develops peritonitis. A non-infectious condition, such as a rupture of a hollow abdominal organ as might happen in abdominal trauma or an inflamed appendix, can cause peritonitis, which can be localized or systemic.

Causes

• An injury or wound to the abdomen
• Rupture of the appendix
• A gastric ulcer
• A colon with holes
• Diverticulitis is a condition in which the colon's wall develops inflammatory pouches.
• Pancreatic inflammation is known as pancreatitis.
• Cirrhosis of the liver or other liver conditions
• Infection of the intestines, blood, or gallbladder
• An infection of a woman's reproductive organs is known as pelvic inflammatory disease.
• An instance of inflammatory bowel disease is Crohn's disease.
• invasive medical procedures, such as surgery, feeding tubes, or kidney failure treatment

Symptoms

• Discomfort or pain in the abdomen
• A feeling of distention or bloating in your belly
• Fever
• Nausea and diarrhoea
• Reduced appetite
• Diarrhea
• Low urination
• Thirst
• Difficulty passing stool or gas
• Fatigue

Nursing management

• If a shock is evident, keep an eye on the patient's blood pressure by arterial line.
• Urine output and central venous or pulmonary artery pressures should be frequently monitored.
• Continually evaluate GI function, fluid and electrolyte balance, and discomfort.
• Examine the type of discomfort, where it is in the abdomen, and whether it is shifting.
• Give analgesic medication and assume a comfortable position (e.g., on your side with your knees bent to relieve pressure on your internal organs).
• Keep track of your intake, output, CVP, and pulmonary artery pressures.
• Give IV fluids carefully supervised; nasogastric intubation may be required.
• Keep an eye out for signs that the peritonitis is easing, such as a lowering of the body's temperature and pulse rate, softening of the belly, the return of peristaltic noises, the passage of flatus, and regular bowel movements.
• When the peritonitis clears up, gradually increase oral and dietary fluid intake while decreasing parenteral fluid consumption.
• If postoperative wound drains have been put, observe and note their nature; take care not to knock them out of place.
• Postoperatively, get the patient and the family ready for discharge; teach them how to take care of the incision and any drains that may still be there.
• If required, suggest home care.

Peritonitis

Peritonitis is an inflammation of the peritoneum, a membrane that protects the organs inside your abdomen and lines your inner abdominal wall. Peritonitis is typically brought on by a bacterial or fungal infection. The peritoneum, a thin layer that lines the interior of the belly and covers the majority of the abdominal organs, becomes inflamed when it develops peritonitis. A non-infectious process, such as a rupture of a hollow abdominal organ as can happen in abdominal trauma or an inflamed appendix, can cause peritonitis, which can be localized or generalized.

Classification

• Rarely occurs primary or bacterial peritonitis, in which the peritoneum spontaneously contracts an infection through the blood and lymphatic systems.
• A visceral organ pathogenic condition is connected to secondary peritonitis.
• After adequate initial therapy, tertiary peritonitis is an infection that persists or returns.

Pathophysiology

Inflammation, infection, ischemia, trauma, or tumor perforation are the most common reasons why abdominal organs' contents seep into the abdominal cavity, leading to peritonsillitis. Escherichia coli, as well as the Klebsiella, Proteus, and Pseudomonas species, are the most frequently mentioned bacteria. Appendicitis, perforated ulcers, diverticulitis, and bowel perforation are additional common causes. Additionally, peritoneal dialysis and abdominal surgery may both cause peritonitis. The most common cause of death from peritonitis is sepsis. The development of bowel adhesion may cause intestinal obstruction.

Causes

• A laceration or damage to the abdomen
• A ruptured appendix,
• A stomach ulcer,
• A perforated colon,
• Diverticulitis, which is when pouches form on the wall of the colon and become inflamed,
• Pancreatitis, which is an infection of the pancreas, cirrhosis of the liver or other forms of liver illness
• Infection of the intestines, circulation, gallbladder, 
• Pelvic inflammatory disease, an infection of a woman's reproductive organs.
• Extensive medical procedures, such as surgery, a feeding tube, or treatment for kidney failure can be used to treat Crohn's disease, an inflammatory bowel illness.

Symptoms

• Discomfort or pain in the abdomen
• A feeling of distention or bloating in your belly
• Fever
• Nausea and diarrhoea
• Reduced appetite
• Diarrhea
• Low urination
• Thirst
• Difficulty passing stool or gas
• Fatigue

Diagnosis

• Your white blood cell count can be determined by a blood test known as a complete blood count (CBC). A high white blood cell count typically indicates an illness or inflammatory process. Finding the germs causing the infection or inflammation may be aided by a blood culture.
• Your doctor can use a needle to collect some of the excess fluid from your abdomen and send it to a lab for fluid analysis. The fluid can also be cultured to assist identify bacteria.
• X-rays and CT scans are imaging examinations that can reveal any perforations or holes in your peritoneum.

Treatment

• Antibiotics: To treat the illness and stop it from spreading, you'll probably be prescribed a course of antibiotics. Your condition's severity and the type of peritonitis you have will determine the sort of antibiotic medication you receive and how long it should last.
• Surgery: When peritonitis is caused by a ruptured appendix, stomach, or colon, surgery is frequently required to remove infected tissue, treat the underlying infection, and stop the infection from spreading.
• Additional therapies: Your hospital treatment may involve painkillers, intravenous (IV) fluids, additional oxygen, and, in some circumstances, a blood transfusion, depending on your signs and symptoms.

Post-operative care

• Keep an eye on your level of awareness, your vital signs, your CVP, your intake, and your output.
• Observe and note the drainage's drain darai attributes (color, number).
• Care must be taken during setup and movement of the patient's position to prevent drain uprooting.
• A surgical wound treatment facility.

Nursing management

• If a shock is evident, keep an eye on the patient's blood pressure by arterial line.
• Urine output and central venous or pulmonary artery pressures should be frequently monitored.
• Continually evaluate GI function, fluid and electrolyte balance, and discomfort.
• Examine the type of discomfort, where it is in the abdomen, and whether it is shifting.
• Give analgesic medication and assume a comfortable position (e.g., on your side with your knees bent to relieve pressure on your internal organs).
• Keep track of your intake, output, CVP, and pulmonary artery pressures.
• Give IV fluids carefully supervised; nasogastric intubation may be required.
• Keep an eye out for signs that the peritonitis is easing, such as a lowering of the body's temperature and pulse rate, softening of the belly, the return of peristaltic noises, the passage of flatus, and regular bowel movements.
• When the peritonitis clears up, gradually increase oral and dietary fluid intake while decreasing parenteral fluid consumption.
• If postoperative wound drains have been inserted, observe and note their nature; take care not to knock them out of place.
• Postoperatively, get the patient and the family ready for discharge; teach them how to take care of the incision and any drains that may still be there.
• If required, suggest home care.

Complications

• Unclean bloodstream (bacteremia).
• You have an infection all over your body (sepsis). Sepsis is a fatal condition that is rapidly progressing and can result in shock and organ failure.