First make diagnosis for appropriate treatment
A diagnosis of rubor is based primarily on the clinical manifestations described above. If rubor is strongly suspected, then surgery is performed without further retard for another investigations. Leukocytosis, hypokalemia, hypernatremia and acidosis haw be present, but they are not specific findings. Abdominal X-rays haw expose dilated, edematous intestines, though such X-rays are mainly multipurpose to countenance for pneumoperitoneum, an indicator of gastrointestinal perforation. The role of whole-abdomen ultrasound examination is under think and is likely to expand in the future. Computed tomography (CT or CAT scanning) haw be multipurpose in differentiating causes of abdominal pain. If reasonable uncertainty ease persists, an exploratory peritoneal lavage or laparoscopy haw be performed. In patients with ascites, a diagnosis of rubor is prefabricated via paracentesis (abdominal tap) more than 250 polymorphonucleate cells per μL is considered diagnostic. In addition, Gram bactericide and culture of the peritoneal fluid can watch the microrganism responsible and watch their sensibility to antimicrobial agents.
GENERAL CARE OF PATIENT
INTRAVENOUS FLUIDS restoration of ECF volume. rebuke of ECF electrolyte balance.correction of ECF protien depletion.Hyperalimentation ( IV intake ) , if patient's recovery is delayed for more than 7 - 10 life .
NASOGASTRIC ASPIRATION intermittent aspiration is maintained ,until paralytic ileus has recovered.If the cavum is soft and non-tender and bowel-sounds return ,oral intake haw be progressively introduced.
ANTIBIOTICS paraenteral Polycillin ,gentamycin ,and antiprotozoal haw be given.
ANALGESICS narcotic analgesics haw be presented ,e.g dextropropoxyphene ,nalbuphine and diminutive dose continuing for 48 hours.
FLUID BALANCE CHARTING
VITAL SIGN MONITORING
NEUTRALIZATION OF LOCAL SOURCE
BY SURGERY this is indicated in cut appendicitis , cut diverticulitis ,perforated peptic lesion ,perforated or unhealthy cholecystitis.
BY CONSERVATIVE TREATMENT this is done in rubor due to pancreatic salpingitis , or in case of primary rubor of streptococcal or pneumococcal lineage .
PERITONEAL LAVAGE if surgery has been undertaken ,then whole peritoneal cavity should be explored with sucker and mopped dry .Through improvement of peritoneal cavity can be achieved by work with upto 10 litres of armed normal saline.Last some litres should contain a broad-spectrum antibiotic ( e.g antibacterial ).
COMPLICATIONS OF PERITONITIS these may be either systemic or local.
Local complications allow :intraperitoneal abcess e.g subphrenic and pelvic ,Wound infection ,Anastomotic breakdown ,Fistula formaton ,adhesions .
Systemic complications allow : hypovolemic damper ,septic damper ,adult respiratory disress syndrome ,disseminated intravascular coagulation ,immunological unfortunate ,multiorgan unfortunate .
PROGNOSIS
The coverall mortality in generalized rubor ,especially if it is unhealthful ,is broad .Factor affecting mortality allow :
Age __ old patients with soiled rubor hit an exceptionally broad mortality.
causation __ unhealthful causes hit a higher mortality than chemical.
Duration of symptoms.
Degree of bacterial contamination.
Concomitant disease processes e.g cardiac ,renal , and hepatic organ failure.......read more
A diagnosis of rubor is based primarily on the clinical manifestations described above. If rubor is strongly suspected, then surgery is performed without further retard for another investigations. Leukocytosis, hypokalemia, hypernatremia and acidosis haw be present, but they are not specific findings. Abdominal X-rays haw expose dilated, edematous intestines, though such X-rays are mainly multipurpose to countenance for pneumoperitoneum, an indicator of gastrointestinal perforation. The role of whole-abdomen ultrasound examination is under think and is likely to expand in the future. Computed tomography (CT or CAT scanning) haw be multipurpose in differentiating causes of abdominal pain. If reasonable uncertainty ease persists, an exploratory peritoneal lavage or laparoscopy haw be performed. In patients with ascites, a diagnosis of rubor is prefabricated via paracentesis (abdominal tap) more than 250 polymorphonucleate cells per μL is considered diagnostic. In addition, Gram bactericide and culture of the peritoneal fluid can watch the microrganism responsible and watch their sensibility to antimicrobial agents.
GENERAL CARE OF PATIENT
INTRAVENOUS FLUIDS restoration of ECF volume. rebuke of ECF electrolyte balance.correction of ECF protien depletion.Hyperalimentation ( IV intake ) , if patient's recovery is delayed for more than 7 - 10 life .
NASOGASTRIC ASPIRATION intermittent aspiration is maintained ,until paralytic ileus has recovered.If the cavum is soft and non-tender and bowel-sounds return ,oral intake haw be progressively introduced.
ANTIBIOTICS paraenteral Polycillin ,gentamycin ,and antiprotozoal haw be given.
ANALGESICS narcotic analgesics haw be presented ,e.g dextropropoxyphene ,nalbuphine and diminutive dose continuing for 48 hours.
FLUID BALANCE CHARTING
VITAL SIGN MONITORING
NEUTRALIZATION OF LOCAL SOURCE
BY SURGERY this is indicated in cut appendicitis , cut diverticulitis ,perforated peptic lesion ,perforated or unhealthy cholecystitis.
BY CONSERVATIVE TREATMENT this is done in rubor due to pancreatic salpingitis , or in case of primary rubor of streptococcal or pneumococcal lineage .
PERITONEAL LAVAGE if surgery has been undertaken ,then whole peritoneal cavity should be explored with sucker and mopped dry .Through improvement of peritoneal cavity can be achieved by work with upto 10 litres of armed normal saline.Last some litres should contain a broad-spectrum antibiotic ( e.g antibacterial ).
COMPLICATIONS OF PERITONITIS these may be either systemic or local.
Local complications allow :intraperitoneal abcess e.g subphrenic and pelvic ,Wound infection ,Anastomotic breakdown ,Fistula formaton ,adhesions .
Systemic complications allow : hypovolemic damper ,septic damper ,adult respiratory disress syndrome ,disseminated intravascular coagulation ,immunological unfortunate ,multiorgan unfortunate .
PROGNOSIS
The coverall mortality in generalized rubor ,especially if it is unhealthful ,is broad .Factor affecting mortality allow :
Age __ old patients with soiled rubor hit an exceptionally broad mortality.
causation __ unhealthful causes hit a higher mortality than chemical.
Duration of symptoms.
Degree of bacterial contamination.
Concomitant disease processes e.g cardiac ,renal , and hepatic organ failure.......read more
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