Peritonitis and bowel obstruction Lecture Presentation :causes, symptoms and treatment NHPC NNC

Peritonitis and bowel obstruction Lecture Presentation : causes, symptoms and treatment NHPC NNC

Table of Content(toc)

Peritonitis and Bowel Obstruction: Lecture Notes (NHPC NNC)

Peritonitis

Peritonitis is the inflammation of the peritoneum, the membrane lining the abdominal cavity and covering the organs within it.

Causes

1. Infectious Causes

   • Bacterial or fungal infection (e.g., ruptured appendix, perforated peptic ulcer).
   • Post-surgical infections.

2. Non-Infectious Causes

   • Chemical irritation (e.g., bile or gastric acid leakage).
   • Autoimmune diseases.

Symptoms

• Severe abdominal pain and tenderness.
• Abdominal distension.
• Fever and chills.
• Nausea and vomiting.
• Loss of appetite.
• Rapid heart rate.
• Decreased or absent bowel sounds.

Diagnosis

• Physical Examination: Rebound tenderness, rigidity.
• Imaging: X-ray, ultrasound, CT scan (to detect free air or fluid).
• Laboratory Tests: Elevated white blood cell count, blood cultures.
• Paracentesis: Analysis of peritoneal fluid.

perforation peritonitis gas under diaphragm

Treatment

1. Medical Management

   • Broad-spectrum antibiotics.
   • Pain management.
   • Intravenous fluids to prevent dehydration.

2. Surgical Management

   • Source control (e.g., repair of perforations, abscess drainage).
   • Laparotomy or laparoscopy.

3. Post-Treatment Care

• Monitor for signs of sepsis.
• Nutritional support.

bowel obstruction

Bowel Obstruction

Bowel obstruction refers to a blockage that prevents the normal passage of contents through the intestines.

Causes

1. Mechanical Obstruction

   • Adhesions (post-surgery).
   • Hernias.
   • Tumors.
   • Volvulus (twisting of the bowel).
   • Intussusception (telescoping of bowel).

2. Non-Mechanical Obstruction (Ileus)

   • Post-surgical paralysis of the intestines.
   • Electrolyte imbalances.
   • Medications (e.g., opioids).

Symptoms

• Cramping abdominal pain.
• Nausea and vomiting (may include feculent material).
• Abdominal distension.
• Inability to pass gas or stool.
• High-pitched bowel sounds (early stage) or absent bowel sounds (late stage).

Diagnosis

• Physical Examination: Abdominal tenderness, distension.
• Imaging: X-ray (air-fluid levels), CT scan (site of obstruction).
• Blood Tests: Check for electrolyte imbalances and dehydration.

small  bowel obstruction x ray

Treatment

1. Medical Management

   • NPO (nil per os, nothing by mouth).
   • Nasogastric tube for decompression.
   • Intravenous fluids to prevent dehydration.
   • Correction of electrolyte imbalances.

2. Surgical Management

   • Removal of the obstruction (e.g., resection, adhesiolysis).
   • Colostomy or ileostomy if needed.

3. Post-Treatment Care

   • Gradual reintroduction of oral intake.
   • Monitor for recurrence.

Key Points

• Early diagnosis and treatment are critical for both conditions to prevent complications like sepsis or bowel perforation.
• Multidisciplinary care is often required, including surgical and medical interventions.
• Patient education and follow-up are vital for long-term recovery and prevention.

Peritonitis and bowel obstruction PPT