Intra belly infections
Contents:
Description:
Peritoneal infections usually arise at disturbance of normal anatomic barriers. Normal the peritoneal space is sterile. The typical representative of intra belly infections can be considered peritonitis.
Reasons of intra belly infections:
Peritonitis happens primary (without visible disturbing factor) or secondary. At adults primary or spontaneous bacterial peritonitis meets among patients with alcoholic cirrhosis more often and almost always develops at ascites. The pathogeny is connected with ascites when the liver at disturbance of portal blood circulation is incapable to perform filtering function. The infection is, as a rule, caused by monoflora with the accompanying bacteremia.
Secondary peritonitis develops when bacteria infect an abdominal cavity as a result of their receipt from the intraabdominal center. At secondary peritonitis usually there is mixed aerobic and anaerobic microflora.
Symptoms of intra belly infections:
Fever is noted at 80% of patients with primary peritonitis. Abdominal pains, acute development of symptomatology, symptoms of damage of an abdominal cavity at a physical research are diagnostically significant, however, lack of these signs does not exclude the diagnosis. Ascites, as a rule, precedes an infection.
Intra belly infection (diffuse peritonitis)
Secondary peritonitis:
The local symptomatology depends on a provocative factor. At perforation of stomach ulcer pain in epigastriums develops. At appendicitis initial symptoms are indistinct and include nausea, the sensation of discomfort in paraumbilical area which is gradually moving to the right lower quadrant. Symptoms of secondary peritonitis include the abdominal pain amplifying at the movement, cough, sneezing. The patient usually tightens knees to a stomach for reduction of a tension of peritoneal nerves. At survey of an abdominal cavity any and involuntary tension of an abdominal wall, at late stages - the irradiating pain is defined.
Diagnosis:
For diagnosis of primary peritonitis punktirut an abdominal cavity at each in a fever patient with cirrhosis. Peritoneal liquid is collected in sterile ware with a medium to improve effectiveness of its cultural research. Blood is also checked for sterility. At suspicion of secondary peritonitis diagnosis is sent to search for a provocative factor; punktirut an abdominal cavity for receiving liquid seldom.
Treatment of intra belly infections:
At primary peritonitis it is directed to recovery of the patient. Includes suppression of gram-negative aerobes and gram-positive cocci. If at the patient with suspicion of peritonitis the mixed microflora is sowed (in particular, anaerobe bacterias), it is necessary to exclude secondary peritonitis. Treatment at secondary peritonitis includes the antibiotics directed against aerobes, gram-negative microbes and anaerobe bacterias along with the surgical intervention removing the cause.
