Clinical Gastroenterology Vol.34 No.8(2-1)

Theme Advancement of Medical Practice for Peritonitis and Ascites
Title Secondary Peritonitis
Publish Date 2019/07
Author Manabu Kaneko Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo
Author Soichiro Ishihara Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo
[ Summary ] Acute bacterial peritonitis is a condition in which inflammation has spread from the gastrointestinal tract or urogenital organs to the peritoneum. Common causes of acute bacterial peritonitis include appendicitis, cholecystitis, and a large intestinal perforation. Severe inflammation and subsequent deterioration in the patient's medical condition can cause a severe state of generalized peritonitis, endotoxic shock, and multiorgan dysfunction. Only physical examination and blood tests cannot accurately diagnose this condition: therefore, imaging studies such as computed tomography (CT) or ultrasonography are required. Treatment of acute bacterial peritonitis includes immediate initiation of fluid resuscitation and antibiotic administration to improve the patient's general condition, followed by measures to control the septic focus surgically or via percutaneous drainage. In this section, we outline the pathophysiology of acute bacterial peritonitis, the diagnostic methods, and the treatment strategies for this condition.
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