Symptoms of acute peritonitis

summary

Acute peritonitis is a common surgical acute abdomen. Its pathological basis is that the peritoneal wall and / or visceral layer are stimulated or damaged for various reasons, resulting in acute inflammatory reaction, which is mostly caused by bacterial infection, chemical stimulation or physical injury. Most of them were secondary peritonitis, which originated from abdominal organ infection, necrosis, perforation, trauma and so on. The typical clinical manifestations of peritonitis are abdominal tenderness, abdominal muscle tension and rebound pain, as well as abdominal pain, nausea, vomiting, fever, high white blood cells. In severe cases, it can cause blood pressure drop and systemic toxic reaction. If it is not treated in time, it can die of toxic shock. Some patients may have pelvic abscess, intestinal abscess, subphrenic abscess, iliac fossa abscess, adhesive intestinal obstruction and other complications. Let's talk about the symptoms of acute peritonitis

Symptoms of acute peritonitis

1. Nausea and vomiting: the peritoneum is stimulated, causing reflex nausea and vomiting. The vomit is the contents of the stomach, sometimes with bile; Later, due to paralytic ileus, vomiting became persistent without nausea. The vomit could be yellow green bile, or even brown fecal content

2. Abdominal pain abdominal pain is the most common symptom, most of which occur suddenly, persist and expand rapidly. Its nature depends on the type of peritonitis (chemical or bacterial), the scope of inflammation and the reaction of patients. When diffuse peritonitis is caused by acute perforation of stomach, duodenum, gallbladder and other organs, when the digestive fluid stimulates the peritoneum, it suddenly produces strong abdominal pain, and even produces the so-called peritoneal shock. In a few cases, the symptoms of abdominal pain and peritoneal irritation were relieved temporarily because of peritoneal exudation and diluting irritants before bacterial secondary infection; After secondary bacterial infection, abdominal pain is aggravated again. Peritonitis caused by bacterial infection usually begins with local pain of the primary focus (such as appendicitis, cholecystitis, etc.), and the abdominal pain is relatively slow when perforation occurs, showing flatulence or dull pain, which is not as severe as acute perforation of stomach and gallbladder, and the pain gradually aggravates and spreads from the focus area to the whole abdomen. The degree of abdominal pain varies from person to person. Some patients report severe persistent pain, while others only report dull pain or discomfort

3. When peritonitis is caused by acute perforation of hollow viscera, collapse is common due to peritoneal shock or toxemia. At this time, the body temperature is usually lower than or close to normal; When the collapse improved and the peritonitis continued to develop, the body temperature began to increase gradually. If the primary disease is acute infection (such as acute appendicitis and acute cholecystitis), the body temperature is often higher than the original in the occurrence of acute peritonitis. In patients with acute diffuse peritonitis, the effective circulating blood volume and total blood potassium were significantly reduced due to peritoneal exudation, high congestion and edema of peritoneum and intestinal wall, accumulation of a large amount of fluid in paralyzed intestinal cavity, vomiting and water loss. In addition, due to the decrease of renal blood flow, the aggravation of toxemia, the impairment of heart, kidney and peripheral vascular function, patients often have hypotension and shock, pulse count or can not be touched, thirst, oliguria or anuria, abdominal distension, no anal exhaust. Sometimes there are frequent hiccups, the reason may be that inflammation has spread to the diaphragm.

matters needing attention

Eat a small amount of food, avoid eating raw and cold, stimulating food, diet should be regular; Avoid heavy physical labor; Keep a good mood; If the abdomen is not in good time, return to the doctor as soon as possible.