DEFINITION

The peritonitis is the (sudden) sharp inflammation of the peritoneum. The peritoneum is the membrane that limits the wall of the abdomen and covers the abdominal organs.

CAUSES, INCIDENCE AND FACTORS OF RISK

The sharp peritonitis can be spontaneous – rare illness, in which the peritoneum becomes infected for blood route; it usually complicates some hepatic cirrhoses – or much more often, it would help to many causes, such as:

• Perforation of a víscera covered by the peritoneum.
• Abdominal traumas or blood of any origin in the peritoneum.
• Intestinal occlusion with strangulation of the digestive pipe.
• Pancreatitis.
• Vascular catastrophes of the abdomen (Thrombosis mesentérica).
• Inflammatory illness of the pelvis, in turn would help to many causes (intrauterine devices, pregnancy ectópico, gonococias or other sexually transmitted diseases, septic abortions).

SYMPTOMS

The typical peritonitis symptoms are those of a sharp abdomen, that is to say, those of a picture of maximum abdominal pain of sudden beginning. He accompanies himself of morning sickness, vomiting, high fever and important general discomfort.

DIAGNOSIS

Physical examination. Pain and defense on having felt the abdomen (it hurts more on having released than on having been too tight). Lacking in noises. Fever. Gravity.

Blood test. The white globules are increased in the blood.

Simple abdomen radiography: When there is a perforation, it is possible to see just gas under the diaphragm.

Most of the peritonitises, nevertheless, is diagnosed for laparotomía, that is to say, producing straight the abdomen after a strong peritonitis suspicion.

TREATMENT

In general, the peritonitis is a surgical urgency, and precise urgent surgery that includes identification and precocious treatment of the cause.

PROGNOSIS AND COMPLICATIONS

Without treatment, the peritonitis is complicated quickly with dehydration and the called multiple organ mistake, which usually provokes the death of the patient in a few days.

With the surgery and the correct measurements of support, it usually evolves to the healing.

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