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56 - Peritonitis

from Part VII - Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen

Published online by Cambridge University Press:  05 March 2013

Linda A. Slavoski
Affiliation:
Doctor of Infectious Disease Medicine and Internal Medicine, Wilkes Barre, Pennsylvania
Matthew E. Levison
Affiliation:
Drexel University School of Public Health
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
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Summary

Peritonitis is inflammation of the serous lining of the peritoneal cavity. This inflammation may result from a response to microorganisms and/or chemical irritants, such as blood, bile, and pancreatic secretions. The peritoneal cavity is lubricated with 20 to 50 mL of clear yellow transudative fluid, normally with fewer than 300 cells/mm3 (consisting of mainly mononuclear cells), a specific gravity below 1.016, and protein (consisting of mainly albumin) below 3 g/dL.

In this chapter infectious causes of peritonitis are considered. Two major types of infective peritonitis exist: (1) primary (spontaneous or idiopathic) and (2) secondary. When signs of peritonitis and sepsis persist after treatment for secondary peritonitis and no pathogens or usually only low-grade pathogens are isolated, the clinical entity has been termed tertiary peritonitis. Intraperitoneal abscesses can result from (1) localization of the initially diffuse peritoneal inflammatory response to one or more dependent sites (ie, the pelvis, the right or left subphrenic spaces, which are separated by the falciform ligament, and Morrison's pouch, which is the most posterior superior portion of the subhepatic space and is the lowest part of the paravertebral groove when the patient is recumbent) or (2) at the site of the intra-abdominal source of the infection (eg, periappendiceal, pericholecystic, or peridiverticular abscess). Peritonitis may also result from the use of a peritoneal catheter for dialysis or central nervous system ventriculoperitoneal shunting. For management of peritoneal catheter-related peritonitis, see Chapter 94, Dialysis-Related Infection.

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Publisher: Cambridge University Press
Print publication year: 2008

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  • Peritonitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.057
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  • Peritonitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.057
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Peritonitis
  • Edited by David Schlossberg
  • Book: Clinical Infectious Disease
  • Online publication: 05 March 2013
  • Chapter DOI: https://doi.org/10.1017/CBO9780511722240.057
Available formats
×