Secondary Bacterial Peritonitis: Etiology, Clinical features, Diagnosis, Management: Surgery скачать в хорошем качестве

Secondary Bacterial Peritonitis: Etiology, Clinical features, Diagnosis, Management: Surgery

📌 𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:-   / drgbhanuprakash   📌𝗝𝗼𝗶𝗻 𝗢𝘂𝗿 𝗧𝗲𝗹𝗲𝗴𝗿𝗮𝗺 𝗖𝗵𝗮𝗻𝗻𝗲𝗹 𝗛𝗲𝗿𝗲:- https://t.me/bhanuprakashdr 📌𝗦𝘂𝗯𝘀𝗰𝗿𝗶𝗯𝗲 𝗧𝗼 𝗠𝘆 𝗠𝗮𝗶𝗹𝗶𝗻𝗴 𝗟𝗶𝘀𝘁:- https://linktr.ee/DrGBhanuprakash Secondary Bacterial Peritonitis: Etiology, Clinical features, Diagnosis, Management approach - ------------------------------------------------------------------------------------------------------------- Etiology - Gastrointestinal Tract Perforation: Peptic ulcer perforation. Diverticulitis. Appendicitis. Trauma causing intestinal rupture. Postoperative Complications - Anastomotic leaks following gastrointestinal surgery. Bowel Ischemia: Strangulation of bowel from hernia or volvulus can lead to ischemia, necrosis, and eventual perforation. Penetrating Abdominal Trauma: Gunshot wounds or stab injuries can introduce pathogens directly into the peritoneal cavity. Clinical Features - The clinical presentation of secondary peritonitis is often acute and severe, with systemic signs of infection. Key features include: Severe Abdominal Pain: Diffuse, often starting locally at the site of perforation and rapidly spreading to the entire abdomen. Fever and Chills: High-grade fever is common due to bacterial infection. Signs of Peritonism: Rebound tenderness (pain upon release of pressure). Rigidity of the abdominal wall due to reflex muscular spasm. Tachycardia and Hypotension: Signs of sepsis due to systemic inflammatory response. Nausea and Vomiting: May accompany the infection and inflammation. Distended Abdomen: Due to paralytic ileus and accumulation of gas and fluid. Altered Bowel Movements: Constipation or absence of bowel sounds may indicate ileus. Signs of Shock: As infection worsens, patients may develop signs of septic shock, including confusion, cold extremities, and multiorgan failure. Diagnosis - Prompt diagnosis is critical to prevent life-threatening complications. The diagnosis is often clinical but confirmed with imaging and laboratory tests: Laboratory Findings - Leukocytosis with a high white blood cell count. Elevated C-reactive protein (CRP) and procalcitonin indicating infection. Blood cultures to identify bacteremia. Abdominal X-Ray: May show free air under the diaphragm (pneumoperitoneum), indicating perforation of a hollow organ. Abdominal Ultrasound: Useful to detect fluid collections or abscesses. CT Scan with Contrast: Gold standard imaging to locate the source of infection, visualize the extent of the peritonitis, and detect perforations, abscesses, or fluid collections. Helps guide surgical intervention. Paracentesis: A diagnostic and sometimes therapeutic procedure where fluid is aspirated from the peritoneal cavity. Analysis of the fluid may show high white blood cell count, low glucose levels, and positive bacterial cultures. Management Approach - Management of secondary bacterial peritonitis requires urgent surgical intervention, broad-spectrum antibiotics, and supportive care: 1. Resuscitation and Supportive Care Intravenous fluids to correct dehydration and maintain blood pressure. Electrolyte correction. Vasopressors for patients in septic shock. Nutritional support once stabilized. 2. Broad-Spectrum Antibiotics Empiric therapy is initiated before culture results are available, targeting aerobic and anaerobic bacteria. Common regimens include piperacillin-tazobactam, meropenem, or a combination of ceftriaxone with metronidazole. Therapy is later tailored based on culture results. 3. Surgical Intervention The mainstay of treatment is surgical correction of the underlying cause: Laparotomy or laparoscopy to identify and repair the perforated organ. Peritoneal lavage to cleanse the abdominal cavity of infectious material. Abscess drainage or resection of necrotic tissue. Complications - Septic Shock: Due to overwhelming infection and systemic inflammatory response. Multiorgan Failure: Including kidney failure, respiratory failure, and cardiac complications. Abscess Formation: Localized infections can form intra-abdominal abscesses requiring drainage. Adhesions: Postoperative adhesions may form, causing chronic pain and bowel obstruction. #Peritonitis #BacterialInfection #SurgicalEmergency #AbdominalPain #Sepsis #EmergencyCare #SurgeryLife #MedicalAwareness #CriticalCare #medicalanimations #fmge #fmgevideos #rapidrevisionfmge #fmge2024 #mbbslectures #nationalexitexam #nationalexittest #neetpg #usmlepreparation #usmlestep1 #fmge #usmle #drgbhanuprakash #medicalstudents #medicalstudent #medicalcollege #neetpg2025 #usmleprep #usmlevideos #usmlestep1videos #medicalstudents #neetpgvideos #usmlestep2videos