-
What are the layers of the peritoneum? (3)
subserosa (deeper layer), serosa (single layer of mesothelial cells), lymphatic collection on surface of diaphragm
-
Where does lymphatic collection occur in the abdomen?
small stomata on surface of diaphragm
-
What ways can the peritoneum become inflammed? (2)
trauma, bacteria
-
How can we characterize peritonitis? (2)
localized peritonitis (GI contamination, ulcers), diffuse peritonitis (failure to control localized infection)
-
How does pain arise with peritonitis?
afferent nerve endings in the parietal serous membrane of the peritoneum [visceral peritoneum does not have a lot of nerve endings....in the abdomen during a DA and they don't react]
-
How does healing of the peritoneum occur?
by regeneration or by adhesion formation- fibrin deposition or omental adhesions
-
Contrast fibrinious from fibrous adhesions.
fibrinous are acute and can be dissolved by fibrinolysis; fibrinous become fibrous in 7-10 days and that is permanent
-
Describe primary peritonitis.
no identifiable peritoneal source (hematogenous? lymphatic?), usually monomicrobial
-
Primary peritonitis is more common in _________ [species].
cats
-
Describe secondary peritonitis.
usually GI in origin from perforated ulcer, GI foreign body, ischemic intestine, dehisced anastomosis, rectal tear; usually polymicrobial (E. coli is common),
-
What are causes of secondary peritonitis? (5)
GI, urogenital, abdominal abscess, bile, iatrogenic
-
What are clinical signs of peritonitis? (7)
fever, inappetence, ileus/decreased feces, abdominal discomfort, vomiting (SA), diarrhea, SIRS/sepsis
-
What clinicopathologic abnormalities may be present with peritonitis? (4)
WBC normal/increased/decreased, hyperfibrinogenemia, hypovolemia (increased PCV), hypoproteinemia (loss into peritoneal space)/ maybe high globulins
-
What are findings on abdominal US with peritonitis? (3)
free echogenic fluid in peritoneum, intestinal abnormalities (thickened walls, poor motility/ileus), +/- abdominal abscess (if that's the cause)
-
What radiographic findings might be present with peritonitis in SA? (3)
loss of serosa detail (b/c of fluid), pneumoperitoneum, +/- foreign body (if cause)
-
Describe normal abdominal fluid as taken on abdominocentesis. (4)
straw colored, clear, WBC< 5000/μL, TP< 2.5 g/dL
-
What might you find on abdominocentesis with septic peritonitis? (7)
cloudy, increased TP, increased cell count (neutrophils that may be degenerate), increased lactate, decreased glucose, +/- organic debris, +/- bacteria
-
What are causes for non-spectic peritonitis? (2)
common after abdominal surgery, sterile uroabdomen
-
How can you tell the difference between GI rupture and enterocentesis on abdominocentesis?
may see plant material and mixed bacterial pop with both; BUT enterocentesis will not have an inflammatory response; GI rupture will have degenerate neuts and intracellular bacteria and these animals will have signs of septic shock
-
Describe medical treatment of peritonitis. (4)
supportive care (fluids, nutrition), pain management, NSAIDs, antibiotics (broad spectrum, culture)
-
Indications for surgical treatment of peritonitis. (4)
toxic/degenerate neutrophils on cytology, intracellular bacteria (esp polymicrobial), suspect GI leakage (first 2 point to this), peritoneal drainage and lavage
-
Describe adhesion prevention in horses after abdominal surgery. (8)
anti-inflammatories, good surgical technique, antibiotics, peritoneal lavage, sodium carboxymethycellulose (when manipulating intestine at surgery), fucoidan (Peridan- intraperitoneal barrier), omentectomy, heparin
-
What are the most common causes of peritonitis in SA? (2)
GI perf, pyometra
-
What empiric antibiotics are commonly used in SA with peritonitis? (4)
Ampicillin, Sulbactam, Enrofloxacin, Metronidazole
-
What are the most common causes of peritonitis in cattle? (3)
traumatic reticuloperitonitis, intra-abdominal abscess, abomasal ulcer perforation
-
Cattle can often _________ peritonitis by __________.
wall off; local fibrin formation
-
What is empiric treatment for peritonitis in cattle?
third generation cephalosporin
-
What are the most common causes of peritonitis in horses? (3)
intra-abdominal abscess, uterine tear during foaling, GI perf or ischemia
-
Horses with primary peritonitis caused by __________ have an excellent prognosis.
Actinobacillus equuli
-
What empiric antibiotics are used in horses with peritonitis? (4)
penicillin, gentamicin, enrofloxacin, metronidazole
|
|