Secondary peritonitis causes: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary peritonitis has numerous causes. It most often results from entry of enteric bacteria into the peritoneal cavity through a necrotic defect in th wall of the intestines or other viscus as a result of obstruction, infarction or after rupture of an intra-abdominal visceral abscess. It most often occurs after perforation of appendix. Nonbacterial causes of peritonitis include leakage of blood into the peritoneal cavity due to rupture of a tubal pregnancy, ovarian cyst, or aneurysmal vessel. | Secondary peritonitis has numerous causes. It most often results from entry of [[Enterobacteria|enteric bacteria]] into the [[peritoneal cavity]] through a necrotic defect in th wall of the [[intestines]] or other viscus as a result of [[obstruction]], [[infarction]] or after rupture of an [[Abscess|intra-abdominal visceral abscess]]. It most often occurs after [[perforation]] of [[appendix]]. Nonbacterial causes of [[peritonitis]] include leakage of blood into the [[peritoneal cavity]] due to rupture of a [[tubal pregnancy]], [[ovarian cyst]], or [[Aneurysm|aneurysmal vessel]]. | ||
==Causes== | ==Causes== | ||
===Life-Threatening Causes=== | ===Life-Threatening Causes=== | ||
* Solid organ rupture | * Solid organ rupture | ||
* Perforated peptic ulcer | * [[Perforated peptic ulcer]] | ||
* Tubo- | * [[Abscess|Tubo-ovarian abscess]] | ||
* Small | * [[Bowel perforation|Small bowel perforation]] | ||
===Common causes=== | ===Common causes=== | ||
Common causes of secondary peritonitis include:<ref name="pmid2293571">{{cite journal| author=Akriviadis EA, Runyon BA| title=Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis. | journal=Gastroenterology | year= 1990 | volume= 98 | issue= 1 | pages= 127-33 | pmid=2293571 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2293571 }} </ref><ref name="pmid15846719">{{cite journal| author=Wong PF, Gilliam AD, Kumar S, Shenfine J, O'Dair GN, Leaper DJ| title=Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults. | journal=Cochrane Database Syst Rev | year= 2005 | volume= | issue= 2 | pages= CD004539 | pmid=15846719 | doi=10.1002/14651858.CD004539.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15846719 }} </ref> | Common causes of secondary peritonitis include:<ref name="pmid2293571">{{cite journal| author=Akriviadis EA, Runyon BA| title=Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis. | journal=Gastroenterology | year= 1990 | volume= 98 | issue= 1 | pages= 127-33 | pmid=2293571 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2293571 }} </ref><ref name="pmid15846719">{{cite journal| author=Wong PF, Gilliam AD, Kumar S, Shenfine J, O'Dair GN, Leaper DJ| title=Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults. | journal=Cochrane Database Syst Rev | year= 2005 | volume= | issue= 2 | pages= CD004539 | pmid=15846719 | doi=10.1002/14651858.CD004539.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15846719 }} </ref> | ||
* | * [[Perforated peptic ulcer|Perforated PUD]] | ||
* [[Appendicitis]] | * [[Appendicitis]] | ||
* [[Diverticulitis]] | * [[Diverticulitis]] | ||
* | * [[Acute cholecystitis]] | ||
* [[Pancreatitis]] | * [[Pancreatitis]] | ||
* Post-surgical complications | * Post-surgical complications | ||
| Line 28: | Line 28: | ||
|- | |- | ||
! style="width: 35%;" | Perforation of a hollow viscus organ | ! style="width: 35%;" | Perforation of a hollow viscus organ | ||
! style="width: 20%;" |Disruption of the peritoneum | ! style="width: 20%;" |Disruption of the [[peritoneum]] | ||
!Leakage of sterile body fluids into the peritoneum | !Leakage of sterile body fluids into the [[peritoneum]] | ||
!Sterile abdominal surgery | !Sterile [[abdominal surgery]] | ||
!Rarer non-infectious causes | !Rarer non-infectious causes | ||
|- | |- | ||
| valign="top" | '''''Perforation of a hollow viscus''''' (most common cause of peritonitis) | | valign="top" | '''''[[Bowel perforation|Perforation of a hollow viscus]]''''' (most common cause of [[peritonitis]]) | ||
* Perforation of the [[Esophagus|distal esophagus]] ([[Boerhaave syndrome]]) | * Perforation of the [[Esophagus|distal esophagus]] ([[Boerhaave syndrome]]) | ||
* Perforation of the [[stomach]] ([[peptic ulcer]], [[Gastric carcinoma]]) | * Perforation of the [[stomach]] ([[peptic ulcer]], [[Gastric carcinoma]]) | ||
| Line 63: | Line 63: | ||
* [[Menstruum]] (e.g. [[salpingitis]]), | * [[Menstruum]] (e.g. [[salpingitis]]), | ||
* [[Pancreatic juice]] ([[pancreatitis]]), | * [[Pancreatic juice]] ([[pancreatitis]]), | ||
These body fluids are sterile at first, they frequently become infected once they leak out of their organ, leading to infectious peritonitis within 24-48h. | These body fluids are sterile at first, they frequently become infected once they leak out of their organ, leading to infectious peritonitis within 24-48h. | ||
|valign=top| | |valign=top| | ||
| Line 79: | Line 80: | ||
!colspan="2" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF| '''Nonperforation secondary peritonitis'''}} | !colspan="2" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF| '''Nonperforation secondary peritonitis'''}} | ||
|- | |- | ||
!Acute appendicitis | ![[Acute appendicitis]] | ||
| | | | ||
* [[β-Hemolytic Streptococcus]] | * [[Streptococcus|β-Hemolytic Streptococcus]] | ||
* [[Klebsiella pneumoniae]] | * [[Klebsiella pneumoniae]] | ||
* [[Clostridium perfringens]] | * [[Clostridium perfringens]] | ||
* [[Enterococcus]] | * [[Enterococcus]] | ||
|- | |- | ||
!Loculated perforation of | ![[Perforated peptic ulcer|Loculated perforation of]] | ||
gastric ulcer | [[Perforated peptic ulcer|gastric ulcer]] | ||
| | | | ||
* [[Escherichia coli]] | * [[Escherichia coli]] | ||
* [[Group D Streptococcus]] | * [[Streptococcus|Group D Streptococcus]] | ||
* [[Bacillus]] species | * [[Bacillus]] species | ||
|- | |- | ||
| Line 97: | Line 98: | ||
| | | | ||
* [[Staphylococcus epidermidis]] | * [[Staphylococcus epidermidis]] | ||
* [[ | * [[Propionibacterium]] species | ||
* [[Fungi]] | * [[Fungi]] | ||
|- | |- | ||
| Line 116: | Line 117: | ||
| | | | ||
* [[Escherichia coli]] | * [[Escherichia coli]] | ||
* [[α-Streptococcus]] | * [[Streptococcus|α-Streptococcus]] | ||
* Unidentified Gram-positive organism | * [[Gram-positive bacteria|Unidentified Gram-positive organism]] | ||
|- | |- | ||
!Colonic ulcer | !Colonic ulcer | ||
| Line 131: | Line 132: | ||
in general | in general | ||
| | | | ||
* Unidentified gram-negative | * Unidentified [[Gram negative|gram-negative coccobacillus]] | ||
* [[Staphylococcus aureus]] | * [[Staphylococcus aureus]] | ||
| Line 151: | Line 152: | ||
!Perforated bowel | !Perforated bowel | ||
| | | | ||
* [[α-streptococcus]] | * [[Streptococcus|α-streptococcus]] | ||
* [[Clostridium]] species | * [[Clostridium]] species | ||
* [[Candida albicans]] | * [[Candida albicans]] | ||
| Line 158: | Line 159: | ||
| | | | ||
* [[Escherichia coli]] | * [[Escherichia coli]] | ||
* [[ | * [[Klebsiella pneumoniae]] | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Surgery]] | |||
Latest revision as of 00:07, 30 July 2020
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Secondary Peritonitis Microchapters |
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Diagnosis |
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Treatment |
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Secondary peritonitis causes On the Web |
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American Roentgen Ray Society Images of Secondary peritonitis causes |
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Directions to Hospitals Treating Spontaneous bacterial peritonitis |
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Risk calculators and risk factors for Secondary peritonitis causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Overview
Secondary peritonitis has numerous causes. It most often results from entry of enteric bacteria into the peritoneal cavity through a necrotic defect in th wall of the intestines or other viscus as a result of obstruction, infarction or after rupture of an intra-abdominal visceral abscess. It most often occurs after perforation of appendix. Nonbacterial causes of peritonitis include leakage of blood into the peritoneal cavity due to rupture of a tubal pregnancy, ovarian cyst, or aneurysmal vessel.
Causes
Life-Threatening Causes
- Solid organ rupture
- Perforated peptic ulcer
- Tubo-ovarian abscess
- Small bowel perforation
Common causes
Common causes of secondary peritonitis include:[1][2]
- Perforated PUD
- Appendicitis
- Diverticulitis
- Acute cholecystitis
- Pancreatitis
- Post-surgical complications
Causes by Source
| Infected Secondary Peritonitis | Non-infected Secondary Peritonitis | |||
|---|---|---|---|---|
| Perforation of a hollow viscus organ | Disruption of the peritoneum | Leakage of sterile body fluids into the peritoneum | Sterile abdominal surgery | Rarer non-infectious causes |
Perforation of a hollow viscus (most common cause of peritonitis)
Other possible causes for perforation
Most common organisms: mixed bacteria |
Most common organisms |
Sterile body fluids such as
These body fluids are sterile at first, they frequently become infected once they leak out of their organ, leading to infectious peritonitis within 24-48h. |
Due to sterile foreign body inadvertently left in the abdomen after surgery (e.g. gauze, sponge) |
|
Causes by Organ System
| Cause of Peforation | Most likely organism |
|---|---|
| Nonperforation secondary peritonitis | |
| Acute appendicitis | |
| Loculated perforation of | |
| Post operative
gastric ulcer perforation |
|
| Loculated perforation of
umbilical hernia |
|
| Colonic ulcer | |
| Loculated perforation of
colonic polypectomy |
|
| Colonic ulcer | |
| Infected
pancreaticpseudocyst |
|
| Postoperative
in general |
|
| Perforation secondary peritonitis | |
| Perforated gastric ulcer | |
| Perforated duodenal ulcer | |
| Perforated bowel | |
| Perforated gallbladder | |
References
- ↑ Akriviadis EA, Runyon BA (1990). "Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis". Gastroenterology. 98 (1): 127–33. PMID 2293571.
- ↑ Wong PF, Gilliam AD, Kumar S, Shenfine J, O'Dair GN, Leaper DJ (2005). "Antibiotic regimens for secondary peritonitis of gastrointestinal origin in adults". Cochrane Database Syst Rev (2): CD004539. doi:10.1002/14651858.CD004539.pub2. PMID 15846719.