Presentation
There were positive correlations between PD effluent CA125 concentrations and total WBC on presentation (r = 0.41, p = CONCLUSION: We did not find any additional diagnostic or prognostic benefit for measuring effluent CA125 in PD patients presenting with [ncbi.nlm.nih.gov]
Entire Body System
- Fever
Abstract Five patients receiving penicillin V potassium or a cephalosporin antibiotic for 18 hours to 22 days developed fever, marked leukocytosis, and signs and symptoms that suggested right-lower-quadrant peritoneal irritation. [ncbi.nlm.nih.gov]
The condition is marked by an accumulation of cells, pus, and other bodily fluids, such as serum and fibrin, in the peritoneal cavity (between the two folds of the peritoneal membrane) and by abdominal pain and distension, vomiting, and fever. [britannica.com]
Loss of appetite Nausea and/or vomiting soon after abdominal pain begins Abdominal swelling Fever of 99-102 degrees Fahrenheit Inability to pass gas Almost half the time, other symptoms of appendicitis appear, including: Dull or sharp pain anywhere in [m.webmd.com]
- Chills
She had symptoms of fever and chilling sensation, general myalgia, and vomiting during three days. The autopsy revealed several needle marks in the lower abdomen and 180ml of bloody exudate in the abdominal cavity. [ncbi.nlm.nih.gov]
Ascitic fluid (or ascites) is a fluid that abnormally accumulates in the peritoneal cavity, commonly in patients with end-stage liver damage Common signs and symptoms of Spontaneous Peritonitis are abdominal pain and tenderness, fever, chills, nausea, [dovemed.com]
Pain may persist for several hours and is worsened by movement or pressure on the abdomen Board-like rigidity of the abdomen, due to contraction of the muscles of the abdominal wall Swollen or bloated abdomen Chills and fever, with profuse perspiration [healthcentral.com]
Other symptoms may include: Fever and chills Passing little or no stools or gas Excessive fatigue Passing less urine Nausea and vomiting Racing heartbeat Shortness of breath The health care provider will perform a physical exam. [medlineplus.gov]
Boardlike rigidity of the abdomen, due to contraction of the abdominal wall muscles Swollen or bloated abdomen Fluid in the abdomen Inability to pass gas or stool Chills and fever, with profuse perspiration Nausea and vomiting Weakness Pale, cold skin [healthcommunities.com]
- Severe Pain
Location of abdominal pain and possible causes Extra-Abdominal Causes of Abdominal Pain Evaluation of mild and severe pain follows the same process, although with severe abdominal pain, therapy sometimes proceeds simultaneously and involves early consultation [msdmanuals.com]
Acute peritonitis is accompanied by a severe pain. The dog usually walks with a stiff gait and the abdominal muscles are rigid in an attempt to guard the abdomen. [gopetsamerica.com]
Peritonitis Other names Surgical abdomen, acute abdomen [1] Peritonitis from tuberculosis Pronunciation Specialty Emergency medicine, general surgery Symptoms Severe pain, swelling of the abdomen, fever [2] [3] Complications Shock, acute respiratory distress [en.wikipedia.org]
Seek immediate medical attention if you develop abdominal pain so severe that you're unable to sit still or find a comfortable position. Call 911 or emergency medical assistance if you have severe abdominal pain following an accident or injury. [mayoclinic.org]
Conversely, secondary peritonitis often presents with prominent symptoms, including severe pain. [uspharmacist.com]
- Rigor
—Usually chilly sensations, or a marked rigor, announce the presence of peritonitis. [henriettes-herb.com]
Fever/rigors. Rash or itching. Urinary symptoms. Recent weight loss. Past medical and surgical history/medication. Gynaecological and obstetric history: Contraception (including intrauterine contraceptive device (IUCD) use). Last menstrual period. [patient.info]
It requires differentiation from paralytic ileus due to other causes of peritonitis High-grade fever with rigors is a sign of infection in body. [ispub.com]
- Acutely Ill Patient
An acutely ill patient usually tries to lie very still, because any amount of movement causes excruciating pain. Often, the patient lies with the knees bent, to decrease strain on the tender peritoneum. There is often nausea and vomiting. [encyclopedia.com]
Respiratoric
- Dyspnea
If the patient develops dyspnea and pneumoderma during or after this procedure, a chest radiogram or thoracoabdominal CT should be taken for diagnostic purposes. [giornalechirurgia.it]
Later, paralysis of the intestine leads to bloating, no longer depart feces and gas, difficulty breathing (dyspnea). General condition progressively deteriorated. Rapidly growing phenomenon of dehydration and intoxication. [survinat.com]
Gastrointestinal
- Abdominal Pain
The old man with sudden continuous abdominal pain resorted to the emergency room and treated for peritonitis associated with acute cholecystitis. [ncbi.nlm.nih.gov]
It is often difficult to ascertain whether abdominal pain in an SLE patient is due to lupus peritonitis or to an underlying cause requiring surgery. [link.springer.com]
A CT scan, preferably with intravenous contrast medium, is now the first choice for radiological assessment of acute abdominal pain and has replaced abdominal x-ray. [tidsskriftet.no]
Abdominal pain is common and often inconsequential. Acute and severe abdominal pain, however, is almost always a symptom of intra-abdominal disease. [msdmanuals.com]
- Vomiting
This report describes the case of a 46-year-old woman who presented with acute peritonitis associated with vomiting and abdominal distension. [ncbi.nlm.nih.gov]
After an appendectomy, call your doctor if you have: Uncontrolled vomiting Increased pain in your abdomen Dizziness /feelings of faintness Blood in your vomit or urine Increased pain and redness in your incision Fever Pus in the wound Can Appendicitis [m.webmd.com]
Nausea and vomiting is an early symptom, the latter causing great pain. In the early stage of the disease, diarrhea is a frequent symptom, but soon gives way to obstinate constipation. [henriettes-herb.com]
- Nausea
Nausea and vomiting is an early symptom, the latter causing great pain. In the early stage of the disease, diarrhea is a frequent symptom, but soon gives way to obstinate constipation. [henriettes-herb.com]
Symptoms Signs and symptoms of peritonitis include: Abdominal pain or tenderness Bloating or a feeling of fullness (distention) in your abdomen Fever Nausea and vomiting Loss of appetite Diarrhea Low urine output Thirst Inability to pass stool or gas [mayoclinic.org]
Ascitic fluid (or ascites) is a fluid that abnormally accumulates in the peritoneal cavity, commonly in patients with end-stage liver damage Common signs and symptoms of Spontaneous Peritonitis are abdominal pain and tenderness, fever, chills, nausea, [dovemed.com]
Nausea and vomiting Physical Examination Vital signs HR: tachycardia BP: hypotension RR: increased and shallow Temp : elevated Neurologic Normal to decreased mentation Skin Pale Flushed Diaphoretic Cardiovascular Pulse thready or wear or may be bounding [nursingcrib.com]
- Acute Abdomen
Tuberculous peritonitis must be considered in the differential diagnosis of acute abdomen in HIV-infected patients on antiviral therapy, especially in patients with known underlying TB. [ncbi.nlm.nih.gov]
Synonym: acute abdominal pain See also the separate article on Abdominal Pain. The term 'acute abdomen' represents a rapid onset of severe symptoms that may indicate life-threatening intra-abdominal pathology. [patient.info]
Peritonitis, acute: Sudden inflammation of the peritoneum that results in abrupt abdominal pain (acute abdomen). [medicinenet.com]
- Constipation
In the early stage of the disease, diarrhea is a frequent symptom, but soon gives way to obstinate constipation. Micturition is frequent, the urine being scanty and high-colored. The appearance of the face is somewhat characteristic. [henriettes-herb.com]
constipation K59.03 Drug induced constipation K59.04 Chronic idiopathic constipation Includes: Functional constipation K59.09 Other constipation Includes: Chronic constipation K59.1 Functional diarrhea Excludes 1: diarrhea NOS (R19.7) irritable bowel [app.drchrono.com]
Abdominal tenderness Abdominal distension Fever Low urine output Point tenderness Thirst Fluid in the abdomen Constipation Inability to pass faeces gas Signs of shock in extreme cases. Diagnoses Physical examination and medical history. [cahabavalleysurgical.com]
From the clinical manifestation data, of 148 patients 100% were having abdominal pain, 52% were experiencing nausea, 48,6% were experiencing vomit, 9,5% were experiencing constipation, 9,5% were experiencing diarrhea, 66,2% were experiencing fever and [repository.unair.ac.id]
Cardiovascular
- Tachycardia
Nausea and vomiting Physical Examination Vital signs HR: tachycardia BP: hypotension RR: increased and shallow Temp : elevated Neurologic Normal to decreased mentation Skin Pale Flushed Diaphoretic Cardiovascular Pulse thready or wear or may be bounding [nursingcrib.com]
[…] experiencing vomit, 9,5% were experiencing constipation, 9,5% were experiencing diarrhea, 66,2% were experiencing fever and 5,4% were experiencing flatulence. 65% of patients had higher body temperature than normal (>37,3 ºC), 62,8% of patients had tachycardia [repository.unair.ac.id]
She had a low-grade fever (38.3 °C), slight tachycardia (regular pulse of 83 beats per minute), slightly reduced oxygen saturation in ambient air (89 %) and normal blood pressure (151/83 mm Hg). [tidsskriftet.no]
- Hypotension
Assess vital signs frequently, noting unresolved or progressing hypotension, decreased pulse pressure, tachycardia, fever, tachypnea. Signs of impending septic shock. [nurseslabs.com]
Nausea and vomiting Physical Examination Vital signs HR: tachycardia BP: hypotension RR: increased and shallow Temp : elevated Neurologic Normal to decreased mentation Skin Pale Flushed Diaphoretic Cardiovascular Pulse thready or wear or may be bounding [nursingcrib.com]
Tachypnoea & Hypotension are poor prognostic features. There was 100% mortality noted among patients who developed hypotension that was poorly responding to vasoconstrictors. [ispub.com]
They may be hypotensive due to dehydration and show signs of septic shock. Bowel sounds may be absent. [patient.info]
Musculoskeletal
- Arthritis
Semin Arthritis Rheum 9:237–247 Google Scholar 8. Martinez D, Lowe R (1991) Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis. Clin Radiol 44:434–435 Google Scholar 9. [link.springer.com]
Melior Discovery inflammation/arthritis Zymosan-A Induced Peritonitis Leukocyte infiltration into a site of injury or irritation is an integral part of an inflammatory process associated with the peritonitis response. [meliordiscovery.com]
Face, Head & Neck
- Hippocratic Facies
The patient’s face becomes drawn into the masklike appearance typical of hippocratic facies. Death occurs within days. [msdmanuals.com]
Workup
Irrespective of the chosen approach, all patients underwent the same preoperative workup (chest X-rays, EKG, and routine blood tests). [wjes.biomedcentral.com]
X-Ray
- Pneumoperitoneum
There is no compelling clinical evidence that specific modifications of the pneumoperitoneum alter immunologic response...presupposing appropriate perioperative measures and hemodynamic stability, there are no contraindication to create a pneumoperitoneum [wjes.biomedcentral.com]
Abdominal X-rays may reveal dilated, edematous intestines, although such X-rays are mainly useful to look for pneumoperitoneum, an indicator of gastrointestinal perforation. [en.wikipedia.org]
We report a case of an accidental bowel wall injury during diagnostic colonoscopic with consequent pneumoperitoneum; this was followed by expansion of gas through diaphragmatic fenestration perhaps congenital, in right pleural cavity causing pneumothorax [giornalechirurgia.it]
The finding of pneumoperitoneum on a standing chest X-ray in combination with severe acute upper abdominal pain, is strongly suggestive for perforated peptic ulcer. A laparotomy will usually follow without additional imaging. [radiologyassistant.nl]
- Bowel Distention
Statistical analysis was performed in order to correlate shunt malfunctioning with type of abdominal approach (trocar vs mini-laparotomy), perioperative infective status, sex, bowel distention and length of surgical time. Results. [giornalechirurgia.it]
Serum
- Neutrophilia
Persistent leukocytosis (esp. neutrophilia) in postoperative period or rise in count suggests some infective foci in body. In our study 15 (75%) patients had persistent neutrophilia after first surgery. [ispub.com]
Acute abdominal symptoms, radiological finding of small bowel PI with massive PMVG, severe neutrophilia, and high serum lactate forced us to perform exploratory laparotomy, from which it was observed a diffuse band-like pneumatosis of all the small bowel [giornalechirurgia.it]
As a rule, the number of white blood cells in the blood (10 000-20 000) and change the formula of white blood neutrophilia with a left shift, lymphopenia and the disappearance of eosinophils. Blood clots found with hematocrit (see). [survinat.com]
Microbiology
- Staphylococcus Aureus
Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA. 2007;208:1763-1771. 7. Rybak MJ, Lomaestro BM, Rotschafer JC, et al. [uspharmacist.com]
Again, in most cases, mixed bacteria are isolated; the most common agents include cutaneous species such as Staphylococcus aureus, and coagulase -negative staphylococci, but many others are possible, including fungi such as Candida. [9] Spontaneous bacterial [en.wikipedia.org]
Recurrence is a concern with certain infections, such as those from Candida and Staphylococcus aureus, and treatment should be continued for 2-3 weeks. Nonoperative Drainage Drainage refers to evacuation of an abscess. [emedicine.medscape.com]
Again, in most cases, mixed bacteria are isolated; the most common agents include cutaneous species such as Staphylococcus aureus, and coagulase-negative staphylococci, but many others are possible, including fungi such as Candida. [intranet.tdmu.edu.ua]
- Neisseria Gonorrhoeae
Common organisms include Neisseria gonorrhoeae and Chlamydia trachomatis. There are four functional compartments within the peritoneal cavity: pelvis, right and left paracolic gutters and the subdiaphragmatic spaces. [surgwiki.com]
Laboratory
- Leukocytosis
Abstract Five patients receiving penicillin V potassium or a cephalosporin antibiotic for 18 hours to 22 days developed fever, marked leukocytosis, and signs and symptoms that suggested right-lower-quadrant peritoneal irritation. [ncbi.nlm.nih.gov]
[…] curves with increased heart rate, not corresponding to the temperature, change the appearance of the patient (the mask of Hippocrates), rapid shallow breathing, the indifference to the surrounding or euphoria, cold sweat, icteric staining of the sclera, leukocytosis [lecheniebolezni.com]
Based on the leukocyte count examination data, 83,1% of all patients were leukocytosis (>10.800 mm3). Conclusion: With the lack of variable, it still needs further studies with more complete data so the acuracy is better. [repository.unair.ac.id]
FOLLOW UP RECOMMENDATIONS Normalization of vital signs with resolution of leukocytosis is a sign of improvement. SBP: PMN decrease >25% is expected if follow-up parace... 2 Panhofer P, Izay B, Riedl M, et al. Age... [5minuteconsult.com]
Treatment
Appropriate identification and treatment of acute bacterial peritonitis are keys to better outcomes. In addition to surgical intervention, pharmacologic treatment is also necessary. [uspharmacist.com]
The prognosis depends on the severity of the peritonitis and on how quickly treatment is started. Without treatment, acute peritonitis can be fatal. [gopetsamerica.com]
Prognosis and complications: Mortality is 10% with modern treatment. Factors responsible for prognosis Load Age Onset of treatment 21. [slideshare.net]
An intelligent and systematic discussion of the treatment of acute peritonitis must necessarily be based on a rational classification. [jamanetwork.com]
Prognosis
The second course results in a localized and circumscribed abscess of the peritoneum and is associated with a more favorable prognosis. [annals.org]
However, the prognosis of the condition is not good. [dovemed.com]
What is the prognosis for a person with peritonitis? The prognosis for individuals who develop peritonitis depends on both the underlying cause and how rapidly the disease is treated. The prognosis can range from good to poor. [medicinenet.com]
A discussion of the etiology, differential diagnosis, prognosis and treatment of acute peritonitis, except upon the basis of a clear and comprehensive classification, is fruitless, misleading and usually results in the deduction of erroneous and often [jamanetwork.com]
Prognosis Prognosis for untreated peritonitis is poor, usually resulting in death. With treatment, the prognosis is variable, dependent on the underlying cause. [encyclopedia.com]
Etiology
Abstract To report etiological and prognostic characteristics of acute peritonitis in children. [ncbi.nlm.nih.gov]
Etiology and pathogenesis THE ACUTE PERITONITIS (PERITONITIS ACUTA) Etiology. [lecheniebolezni.com]
A discussion of the etiology, differential diagnosis, prognosis and treatment of acute peritonitis, except upon the basis of a clear and comprehensive classification, is fruitless, misleading and usually results in the deduction of erroneous and often [jamanetwork.com]
Untreated peritonitis may result in sepsis and end-organ damage; therefore, prompt treatment of bacterial peritonitis should be guided by specific etiology and comorbidities. [uspharmacist.com]
Epidemiology
typically monomicrobial Secondary bacterial peritonitis: infection of ascitic fluid from a detectable intra-abdominal source (i.e., perforation, abscess); typically polymicrobial Tertiary bacterial peritonitis: persistent infection despite therapy Epidemiology [unboundmedicine.com]
DOI PubMed El Guamri Y, Belghyti D, Barkia A, Tiabi M, Aujjar N, Achicha A, Parasitic infection of the digestive tract in children in a regional hospital center in Gharb (Kenitra, Morroco): some epidemiological features. [wwwnc.cdc.gov]
"Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective". World Journal of Gastroenterology. 22 (34): 7742–7. doi : 10.3748/wjg.v22.i34.7742. PMC 5016373. PMID 27678356. ^ Gati GA, Deshpande A (2012). [en.wikipedia.org]
Epidemiology The incidence depends on the cause. In a hospital setting the prevalence of SBP is around 10%. [ 3 ] Three studies of patients with perforated appendicitis found an incidence of postoperative abscess formation of 20%. [patient.info]
[…] considered in patients with cirrhosis who are admitted for upper GI hemorrhage. 12 In the past, norfloxacin 400 mg daily had been the drug of choice in the setting of upper GI hemorrhage; however, alternative antimicrobials have since been considered due to epidemiological [uspharmacist.com]
Pathophysiology
Etiology and Pathophysiology Mechanism SBP: Bacterial translocation via lymphatic spread through mesenteric lymph nodes Cirrhotic patients have: Alterations to gut microbiota with higher prevalence of pathogenic organisms Small intestinal bacterial overgrowth [unboundmedicine.com]
Pathophysiological variability of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res. 2008 ; 102 : 853 – 60. DOI PubMed Kumarasamy V, Kuppusamy UR, Samudi C, Kumar S. [wwwnc.cdc.gov]
Pharmacotherapy: A Pathophysiologic Approach. 8th ed. New York, NY: McGraw-Hill; 2011. 2. Ordonez CA, Carlos J. Management of peritonitis in the critically ill patient. Surg Clin North Am. 2006;86:1323-1349. 3. [uspharmacist.com]
[11] Although fungi are much larger than bacteria, the increased intestinal permeability resulting from advanced cirrhosis makes their translocation easier. [11] SFP is mostly caused by species of Candida and most commonly by Candida albicans. [14] Pathophysiology [en.wikipedia.org]
Prevention
These patients should be managed by complete excision of the urachal remnant to prevent any malignant change occurring, as malignant changes have been reported. [ncbi.nlm.nih.gov]
Nursing Care Plans Early treatment of GI inflammation conditions and preoperative and postoperative therapy help prevent peritonitis. Patient care includes monitoring and measures to prevent complications and the spread of infection. [nurseslabs.com]
Centers for Disease Control and Prevention (CDC) 1600 Clifton Rd. [dovemed.com]
Recognition prevents the appointment of a drug (morphine), which is contraindicated in all cases of suspected peritonitis. [lecheniebolezni.com]