التهاب الصفاق

Definition

Peritonitis is inflammation of the lining of the abdominal cavity.

Types

• Secondary (most common): perforated ulcer, ruptured appendix, anastomotic leak or perforated diverticulitis
• Spontaneous bacterial: in cirrhotic ascites
• Peritoneal dialysis-associated

Symptoms

• Severe diffuse pain worse with movement and coughing
• The client lies still
• Board-like rigidity and rebound tenderness
• Reduced or absent bowel sounds
• Fever and tachycardia, possibly progressing to septic shock

Diagnosis

Examination, labs, CT, and fluid tap when ascites is present.

Treatment

• NPO, NG tube and IV fluids
• Early IV antibiotics
• Source control: surgery or drainage
• Analgesia with urine output and BP monitoring

Nursing care

• Comfortable position with knees flexed
• Watch for shock and sepsis
• Wound and drain care after surgery

Exam point

Sudden diffuse pain with a rigid abdomen after surgery or in an ulcer client is a surgical emergency until proven otherwise.