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  • Peritonitis: Dr. Iwan Budiman, SP.B

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    Jose Antonio Natalino sila
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    Peritonitis is an infection of the abdominal cavity that causes inflammation. It can be caused by perforations, infections, injuries or complications from surgery. Symptoms include abdominal pain, swelling, fever, nausea and vomiting. Diagnosis involves physical exam, lab tests, x-rays and ultrasound to identify the source of infection. Treatment involves intravenous antibiotics and surgery to control sepsis, irrigate the cavity and place drains. Post-operative care focuses on intensive monitoring, hemodynamic stability and continued antibiotics. Complications can be local infections or sepsis that impacts multiple organ systems.

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    Peritonitis

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    Peritonitis is an infection of the abdominal cavity that causes inflammation. It can be caused by perforations, infections, injuries or complications from surgery. Symptoms include abdominal pain, swelling, fever, nausea and vomiting. Diagnosis involves physical exam, lab tests, x-rays and ultrasound to identify the source of infection. Treatment involves intravenous antibiotics and surgery to control sepsis, irrigate the cavity and place drains. Post-operative care focuses on intensive monitoring, hemodynamic stability and continued antibiotics. Complications can be local infections or sepsis that impacts multiple organ systems.

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    © All Rights Reserved
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    18 views16 pages

    Peritonitis: Dr. Iwan Budiman, SP.B

    Uploaded by

    Jose Antonio Natalino sila
    Peritonitis is an infection of the abdominal cavity that causes inflammation. It can be caused by perforations, infections, injuries or complications from surgery. Symptoms include abdominal pain, swelling, fever, nausea and vomiting. Diagnosis involves physical exam, lab tests, x-rays and ultrasound to identify the source of infection. Treatment involves intravenous antibiotics and surgery to control sepsis, irrigate the cavity and place drains. Post-operative care focuses on intensive monitoring, hemodynamic stability and continued antibiotics. Complications can be local infections or sepsis that impacts multiple organ systems.

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    of 16

    PERITONITIS

    Dr. IWAN BUDIMAN, sp.B


    SUBAGIAN BEDAH /RSUD. Sumbawa

    PERITONITIS :
    - Infeksi di rongga abdomen :
    - E/:
    - Perdarahan
    - pus
    - cairan bebas infeksi
    - feses
    - infeksi bakter ,TBCusus

    PERITONITIS :
    - Infeksi di rongga abdomen dan
    inflamasi sbg reaksi di abdomen
    - E/:
    - Perforasi
    - imflamatory
    - Infeksi
    - Inschemic injury
    - perdarahan
    3

    - Secondary Peritonitis :
    - Bactirial Contamination,
    from : - viscera
    - external (eg. Penetrating
    injury)
    - Primary Peritonitis
    - Hemotogenous
    - Transluminal/direct bacterial invasion
    of Peritoneal Cavity

    Common Causes of Peritonitis :


    Severity
    MILD

    Cause
    -Appendicitis
    -Pertorated Gastroduodenal
    ulcers
    -Acute Salpingitis

    MODERATE -Diverticulosis
    -Nonvascular small bowel
    pertoration
    -Gangrenous Cholecystitis
    -Multiple trauma
    SEVERE

    -Large bowel pertorations


    -Ischemic small bowel perforation
    -Acute necrotizing pancreatitis
    -Post operative complication

    Mortality
    Rate
    < 10 %

    < 20 %

    20-80 %

    DIAGNOSTIC :
    A. Simptom( keluhan) dan gejala :
    * Clinical manafestation :
    - demam
    - nyeri dan perut membesar.
    - MUNTAH HIJAU
    - flatus(-) , BAB(-)
    - Age
    - General Health
    * Pemeriksaan fisik utk melihat :
    Adakah riwayat trauma
    abdomen
    6

    * gejala local pada abdomen :


    - nyeri seluruh abdomen
    - Tenderness
    - Distention
    - Bising usus menghilang
    - cairan / udara bebas di
    rongga abdomen

    Gejala sistemik :
    - Fever
    - Tachycardia
    - mual , muntah
    - Tachypnea
    - Dehydration
    - Oliguria
    - Shock

    Laboratory :
    - Darah lengkap
    - Elektrolyte
    - Blood Clotting
    - Liver and renal function test
    - Sample for culture (blood, urine,
    sputum, peritoneal fluid)

    X. Ray :
    - BOF
    - Left lateral decubitus

    10

    TREATMENT:

    O P E R A S I ( LAPAROTOMY )

    11

    12

    TREATMENT:
    A. Preoperative Care
    - intravenous Fluid ( cairan IV)
    - Antibiotics
    B. Operative Management ( Laparotomy)
    - Control sepsis
    - Peritoneal lavage ( cuci rongga
    abdomen)
    - Peritoneal drainage
    - Management of abdominal
    distention
    13

    c. Post operative Care :


    - Intensive care monitoring
    - stabilkan hemodynamic
    - Antibiotics (10-14 days)

    14

    COMPLICATIONS :
    Local :
    - infections dari seluruh usus
    - Intraperitoneal sepsis
    - gangguan anatomy usus
    - Fistula abdomen
    Systemic :
    - Uncontrolled sepsis MODS
    MOF

    15

    TERIMA KASIH

    16

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