Professional Documents
Culture Documents
INFECTION
James Taclin C. Banez, M.D., FPSGS, FPCS
Gross:
II.
Infra-mesocolic spaces:
1.
a)
b)
Gross:
Supra-mesocolic
spaces: falciform
lig.
I.
a)
b)
Right sub-phrenic
space:
suprahepatic space
/ infrahepatic space
Left subphrenic
space: - space bet.
left lobe of liver &
stomach
- lesser sac
ANATOMY:
Microscopic:
I.
Mesothelium 1.8 m2
1.
2.
3.
Stomata
Basement membrane
Connective tissue (collagen,
elastic fiber, fibroblast,
adipose, endothelial cells,
mass cells, machrophage).
Gross:
II.
Intra-abdominal area:
(intraperitoneal /
retroperitoneal)
Intra-peritoneal Space
defined by mesothelial
membrane
a. visceral peritoneum
b. parietal peritoneum
PHYSIOLOGY
Peritoneal fluids:
A.
B.
PHYSIOLOGY
C.
Peritoneal injury:
2.
Adhesion formation:
PHYSIOLOGY
C.
3.
b.
Bacteriology of Intra-abdominal
Infection
A.
B.
10-12
C.
Virulence:
Bacteriology of Intra-abdominal
Infection
Microbial adherence to peritoneum:
D.
Microbial synergy:
E.
a)
b)
Bacteriology of Intra-abdominal
Infection
Host effects on bacterial growth:
F.
Adjuvant substances:
G.
Bacteriology of Intra-abdominal
Infection
Foreign bodies:
H.
Macroscopic:
Surgical drains
Suture
Laparotomy sponges
Hemostatic pads and powder
Surgical clips
Microscopic:
Barium sulfate
Clothing gibers, fecal material
Necrotic tissue
Talcum powder
Laboratory test:
1.
2.
3.
Primary peritonitis:
1.
Primary peritonitis:
1.
ADULT:
CHILDREN:
Diagnostic: PARACENTESIS
B.
C.
Secondary Peritonitis
Usually due to perforation or rupture of intra abdominal hallow viscous organs
Gastrointestinal Tract Perforation:
A.
1.
2.
Secondary Peritonitis
A.
Secondary Peritonitis
A.
3.
Incarcerated hernia
Intussuception
Volvulus
Inflammation
a)
b)
Diverticulitis
Amebic peritonitis
Secondary Peritonitis
B.
Secondary Peritonitis
C.
Post-operative peritonitis:
1.
2.
Secondary Peritonitis
D.
2.
Tertiary Peritonitis
2.
3.
4.
5.
6.
7.
8.
Intra-abdominal Abscess
Management of Intra-abdominal
Infection
2.
3.
8.
Hypovolemic shock
Septic shock
Increased intra-abdominal pressure
Nephrotic drugs (aminoglycoside)
2.
Management of Intra-abdominal
Infection
C.
1.
2.
3.
4.
Management of Intra-abdominal
Infection
C.
Management of Intra-abdominal
Infection
A.
Management of Intra-abdominal
Infection
Lesser Sac Abscess:
B.
D.
Due to:
1. Gastric procedure (most common)
2. Biliary surgery
3. Appendicitis
4. Colonic surgery
Right upper quadrant pain and tenderness
Ultrasound / Ct scan
Management of Intra-abdominal
Infection
E.
Interloop Abscesses:
Management of Intra-abdominal
Infection
Pelvic Abscesses:
F.
Due to:
G.
Management of Intra-abdominal
Infection
Retroperitoneal Abscess:
Due to:
Pancreatitis
Primary or secondary infection of the kidney/ureter/colon
Osteomyelitis of the spine
Trauma
2.
3.
2.
3.
4.
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