1. Peritonitis

2. Anatomy and Physiology
The peritoneum is a thing, double layer of serous membrane in the abdominal cavity
The area of the peritoneum is around
2 square meters

3. Anatomy and Physiology
All organs are divided on 3 groups:
Intraperitoneal
Mesoperitoneal
Extraperitoneal

4. Anatomy and Physiology
Peritoneum tissue
is a typical connective tissue;
is covered by polygonal mesothelium;
has very good plastic peculiarities;
has a very good blood supply.

5. Anatomy and Physiology
The parietal peritoneum is innervated by the sensitive somatic nerves
The pain as a result of the parietal peritoneum irritation is localized (somatic pain)
The pelvic peritoneum has no somatic innervations

6. Anatomy and Physiology
The visceral peritoneum has vegetative (parasympathic and sympathic) innervations
The pain as a result of the visceral peritoneum irritation is not localized

7. Definition
Peritonitis is an inflammation of the peritoneum

8. Classification Acute peritonitis Subacute peritonitis
Chronic peritonitis

9. Classification Primary peritonitis Secondary peritonitis
Meconium peritonitis

10. Classification I Bacterial peritonitis a) staphylococcus
b) streptococcus
c) proteus
d) enterococcus
II Sterile peritonitis
a) caused by bile
b) caused by pancreatic enzymes

11. Classification 1. Serous peritonitis 2. Fibrinous peritonitis
3. Fibrinopurulent peritonitis
4. Purulent peritonitis
5. Hemorrhagic peritonitis
7. Putrid peritonitis

12. Clinical Classification
Local peritonitis
a) encapsulated (abscess)
b) non-encapsulated
II. General peritonitis
a) Diffuse
b) Total

13. Clinical Classification
Stages of Peritonitis
Initial (reactive) stage (up to 24 hours)
Toxic stage ( hours)
Terminal stage (after 72 hours)

14. Clinical features Abdominal pain Tenderness to palpation
Increased abdominal wall rigidity
Anorexia and nausea
Vomiting
Fever
Tachycardia

15. Lab Analyses Leukocytosis or leukocytopenia Dehydration and acidosis
Peritoneal fluid analysis

16. Treatment Antibiotic therapy
Correction of existing serum electrolytes disturbances
Correction of coagulation abnormalities
Surgery

17. Surgery To eliminate the source of contamination
To reduce the bacterial contamination
To prevent further complications and sepsis

18. Thank you