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By;Mr.Mihir.M.Patel,Nursing Tutor,
Government College of Nursing,Siddhpur.
Definition
It is an inflammation of the peritoneum, the serous
membrane lining the abdominal cavity and covering
the viscera.
Etiology/Risk Factors
1.Primary Causes
Bacterial Infection from organisms infecting the GIT.
Cirrhosis and Ascitis: It provide excellence media for
bacterial growth.
2.Secondary Causes
Appendicitis with rupture
Blunt or penetrating injuries to abdominal organ
Diverticulitis with rupture
Ischemic bowel disorders
Obstruction in GIT
Pancreatitis
Perforated Peptic Ulcer
Patient on continuous ambulatory peritoneal dialysis
Pathophysiology
Etiology factors like appendicitis, rupture,diverticulitis,trauma.
Hypovolemia, Shock
Clinical Manifestation
Pain
Rebound Tenderness
Abdomen becomes extremely distended and tender
Paralytic ileus may present
Muscle guarding with rigidity
Nausea and Vomiting
Diminished Peristalsis
Systemic Symptoms Includes;
Fever (100-101F)
Signs of Shock: Tachycardia,Oliguria
Restlessness,weakness,pallor,diaphoresis.
Prolonged peritonitis may cause ARDS.
Diagnostic Evaluation
History Collection
Physical Examination
Blood Investigation
X-ray of abdomen
Peritoneoscopy
Management
Emergency Management
Monitor vital signs,ECG,CVP, Intake and Output
Ratio.
Administer O2 as ordered.
Fluid resuscitation
NG tube insertion to relieve abdominal distention
Initiate TPN within 24-48 hrs.
Bed rest in semi fowlers position to support
ventilation.
Broad spectrum antibiotics
Cont.
Medical Management
Antimicrobial Therapy: Broad spectrum antibiotics,3rd
and 4th generation cephalosporin, amino glycoside.