Modern medicine gives its answer to the question of what is peritonitis. This disease, characterized by inflammation of the leaves of the peritoneum, appears in the form of stress, which is formed when several factors act:
- endogenous (infection, inflammation);
- exogenous (anesthesia, surgical trauma);
- depressive effects on the immune system of stress hormones (cortisol, adrenocorticotropic hormone) released into the blood.
In order to understand what peritonitis is and why it occurs, you need to remember all the organs covered with the peritoneum, since in inflammatory and destructive diseases of the abdominal organs, inflammation of the peritoneum occurs in about 80% of cases. Most often, these are local infectious and inflammatory processes of the abdominal esophagus, various parts of the stomach, duodenum, small and large intestines, appendix, liver, pancreas, biliary tract, and pelvic organs. A special group consists of peritonitis with closed injuries and injuries of the abdomen, as well as those developed as a result of postoperative complications (iatrogenic damage to internal organs, anastomosis failure). The image below shows peritonitis (photo).
Scientists continue to study the problem of peritonitis, as average mortality rates remain quite high (20-30%) and reach 40-50% in severe cases, for example, in postoperative peritonitis. Only by answering the question of what peritonitis is, can you find effective ways to resolve this problem.
In 2000, V. S. Savelyev and a group of co-authors, in order to find an answer to the question of what peritonitis is, proposed a unified classification of these conditions according to the etiological principle. In accordance with it, three main categories of peritonitis are distinguished:
- Primary peritonitis, which develops in the absence of damage to the hollow organs as a result of spontaneous introduction of blood infection into the abdominal integument or through the passage of a specific infection from another organ (for example, tuberculous peritonitis, spontaneous peritonitis). It makes up 1-5% of cases.
- Secondary peritonitis. It occurs most often. It is represented by several varieties: postoperative, post-traumatic - in connection with the destruction or perforation of the abdominal organs. It develops as a local protective reaction of the body to infection.
- Tertiary peritonitis. The most difficult form of diagnosis and treatment, proceeding with the development of so-called persistent or recurrent peritonitis. It develops after operations, injuries, extreme situations, accompanied by a pronounced suppression of the mechanisms of antimicrobial protection. In this case, inflammation is caused by microflora, which survived the first cycle of antibacterial treatment.
Features of the clinical course and the choice of therapeutic tactics are largely determined by the pathological contents of the abdominal cavity, on the basis of which a classification has been created with the allocation of the following forms of peritonitis:
- fecal;
- gall;
- hemorrhagic;
- chemical.
By the nature of the exudate, the following types are distinguished:
- serous fibrinous (serous) peritonitis;
- fibrinous-purulent;
- purulent.
The study of peritonitis continues with the goal of developing a differentiated therapeutic tactic. The choice of classification principles is complicated by the fact that inflammation of the peritoneum is a multifactorial process. However, the development of a classification that can reflect the severity of common symptoms and formulate a reliable prognosis continues.