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Secondary Peritonitis

Signs & Symptoms

 Voluntary guarding
Ref: Uptodate [ Diagnostic approach to abdominal pain in adults] Uptodate [ Differential diagnosis of abdominal pain in adults] Uptodate [ Gastric volvulus in adults]
Nausea #appendicitis
Note: due to appendicitis
Ref: Harrison [ 954]
After some hours pain localized to right lower quadrant #appendicitis
Note: due to appendicitis
Ref: Harrison [ 954]
Periumbilical discomfort #appendicitis
Note: due to appendicitis
Ref: Harrison [ 954]

Physical Examination

 Strict immobility
Note: Peritonitis often causes patients to lie motionless on their backs
Ref: Uptodate [ History and physical examination in adults with abdominal pain]
Voluntary guarding
Ref: Uptodate [ Diagnostic approach to abdominal pain in adults] Uptodate [ Differential diagnosis of abdominal pain in adults] Uptodate [ Gastric volvulus in adults]
Systemic manifestations of sepsis
Ref: Uptodate [ Clinical manifestations and diagnosis of peritonitis in peritoneal dialysis]

Lab / Serology

 Marked leukocytosis
Ref: Harrison [ 954] Cecil [ 897]
Left shift of the WBCs to band forms
Ref: Harrison [ 954]
Elevated peritoneal fluid lipase
Ref: Uptodate [ Clinical manifestations and diagnosis of peritonitis in peritoneal dialysis]

Imagin Study

Complication

Risk Factors

Cause

 Caused by bowel perforation
Note: may have stool in the dialysate
Ref: Uptodate [ Clinical manifestations and diagnosis of peritonitis in peritoneal dialysis] Cecil [ 897]
Caused by endogenous bacteria
Ref: Harrison [ 955]
Caused by perforation of appendix
Ref: Harrison [ 2302]

Other