PERITONITIS & ACUTE ABDOMEn

ACUTE ABDOMEN AND PERITONITIS

1. ANATOMY

*  The  abdominal cavity and the viscera contained within it  are

   lined  by  a smooth glistening layer  called  the  peritoneum. 

   There are two subdivisions of the peritoneum Fig. 21.1

*  The parietal layer covers the inside of the abdominal cavity.

  

*  The  visceral layer covers   the various organs and these  two

   divisions are continuous with one another

*  The  abdominal  cavity  is divided into a greater  sac  and  a

   lesser sac by the visceral layer of the peritoneum.

   The lower half of the greater sac is further sub-divided  into

   a upper right  half and a lower left half by the attachment of

   the root  of  the mesentry.

*  There is usually about 150 cc of clear straw coloured fluid in

   the peritoneal cavity.  This fluid facilitates the movement of

   abdominal viscera.

*  The  surface  area  provided  by  this  peritoneal  layer   is

   approximately equal to the skin surface area and is more  than

   the surface area provided by the glomeruli of the kidney.

*  This  large   surface  area (1.8 meters) is important  and  is

   made use in peritoneal dialysis in cases of renal failure  for

   it  allows  exchange  of fluids and  electrolytes  across  its

   surface.

*  In  cases of inflammation of the peritoneum due  to  bacterial

   peritonitis, this surface area plays an important part in  the

   clinical  picture for it allows transfer of fluids,  bacterial

   toxins  and  other metabolites across its  surfacee  and  thus

   produces  a state of profound shock and toxaemia seen in  this

   condition.

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