How do you manage intestinal perforation?
Approach Considerations. The mainstay of treatment for intestinal perforation is surgery. Surgery for intestinal perforation is contraindicated in the presence of general contraindications to anesthesia and major surgery, such as severe heart failure, respiratory failure, or multiorgan failure.
How do you manage a patient with peritonitis?
Peritonitis treatment usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body. A common cause of peritonitis is peritoneal dialysis therapy.
What is perforated peritonitis?
Introduction: Perforation peritonitis mostly results from the perforation of a diseased viscus. Other causes of perforation include abdominal trauma, ingestion of sharp foreign body and iatrogenic perforation. The diagnosis is mainly based on clinical grounds.
How do you rule out perforation?
In order to confidently diagnose perforation of the large bowel loop, the presence of extraluminal air, phlegmon and/or abscess, an extraluminal collection of feces and the underlying colonic abnormality should be carefully evaluated on CT images (Fig. 13).
How do you treat perforated viscus?
Common empiric regimens for abdominal sources include: ciprofloxacin + metronidazole, ceftriaxone + metronidazole, piperacillin/tazobactam, or imipenem. Definitive management of perforated viscus requires general surgery intervention.
How do you drain peritonitis?
The two main options for peritoneal drainage include open peritoneal drainage and closed suction drainage (Devey 2013). The traditional method of open peritoneal lavage might be detrimental to protein levels and requires continuous patient monitoring.
Which antibiotics treat peritonitis?
Commonly used antibiotics for the treatment of peritonitis include beta-lactams (penicillins), carbapenems (beta-lactamase−resistant beta-lactams), cephalosporins (semi-synthetic beta-lactams), and quinolones (such as ciprofloxacin).
What are three causes of peritonitis?
What causes peritonitis?
- an abdominal wound, such as a surgical wound.
- an abdominal injury.
- a ruptured appendix.
- a stomach ulcer.
- a perforated colon.
- diverticulitis.
- pancreatitis.
- liver disease, such as cirrhosis of the liver.
How do you confirm perforation?
The gold standard for diagnosis of any perforation is with a CT scan (Fig. 2) confirming the presence of free air and suggesting a location of the perforation (as well as a possible underlying cause).
Is perforation peritonitis a surgical emergency?
One of the most common surgical emergencies is perforation peritonitis. It is commonly seen in a younger age group in the tropical countries (mean age in our study was 37.8 years) as compared to the studies in the West.
What is the prevalence of perforation peritonitis in the US?
Results:A total of 490 patients of perforation peritonitis were included in the study, with mean age of 48.28 years. 54.29% patients were below 50 years and 45.71% patients were above 50 years. There were 54.29% male patients and 45.71% female patients.
What is the pathophysiology of perforation peritonitis?
Introduction:Perforation peritonitis mostly results from the perforation of a diseased viscus. Other causes of perforation include abdominal trauma, ingestion of sharp foreign body and iatrogenic perforation. The diagnosis is mainly based on clinical grounds.
How is peptic ulcer perforation treated?
Patients of peptic ulcer perforation usually had a short history of pain starting in epigastrium followed by generalized tenderness. 34% of these patients had history of NSAID intake for 6 months. 175 such were managed by an omental pedicle repair, in the other 4 cases a feeding jejunostomy was also done due to the large size of the perforation.