PERITONITIS Treatment

TREATMENT

CAUSE

The treatment for early peritonitis will in most cases be related

to the treatment of the disorder that cuases the peritonitis, for

example,  a  case  of peptic ulcer  when  it  perforates  causing

peritonitis and the case is diagnosed in the first 24 hours,  the

treatment  would be directed towards the closing the  perforation

which causes peritonitis.

-  The  treatment  of  early peritonitis  has  to  be  undertaken

   urgently before the signs of fluid loss and toxaemia set in.

-  The  treatment of an established case of peritonitis going  on

   for  a  few days, has to be, supportive since the  patient  is

   very  ill  and  toxic he requires  a  period  of  conservative

   therapy before surgical intervention can be undertaken.

The measure adopted are:

-  Correction  of fluid and electrolyte balances by  infusion  of

   intravenous fluids.

-  Diminishing the quantity of leak into the peritoneal cavity by

   nasogastric suction

-  Relief of pain by prescribing analgesics

-  Giving  of  antibiotics intravenous, e.g.  chloramphenicol  or

   tetracycline.

This  treatment may have to be continued for some time  till  the

patient's general condition imporves.

SURGERY

In  all the cases, some degree of adhesion between the  loops  of

the  intestines would have already occurred.  This would  present

with  symptoms  of  colic or obstruction.  They  can  be  drained

percutaneously with radiologic control.

ABSCESS

The only other indication for surgical intervention would be  the

closed  drainage  of  localized  intra-abdominal  abscesses,  the

common sites are shown in Fig.21.4.

Open  Surgical  intervention  if  undertaken  at  this  stage  if

patients condition permits can at best be for purposes of closure

of the site of leak and drainage of the peritoneal cavity.

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