scholarly journals Generalized peritonitis lead to shock: Diagnosis and management

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Nanda Rachmad Putra Gofur ◽  
◽  
Aisyah Rachmadani Putri Gofur ◽  
Soesilaning tyas ◽  
RizkiNur Rachman Putra Gofur ◽  
...  

The peritoneum is a membrane consisting of one layer of mesothelic cells which is separated from the vascular connective tissue underneath by the basement membrane. It forms a closed pouch where the visera can move freely inside. The peritoneum includes the abdominal cavity as the parietal peritoneum and bends to the organs as the visceral peritoneum (Marshall, 2003).Peritonitis is inflammation of the peritoneum (the serous lining that covers the abdominal cavity and abdominal organs therein). It is an acute form of illness, and is a surgical emergency. Can occur locally or in general, through an infectious process due to intestinal perforation, for example in appendix rupture orcolonic diverticulum, or non-infection, for example due to gastric acid discharge in gastric perforation, bile acid excretion in gallbladder perforation. In women, peritonitis is often caused by infection of the fallopian tubes or ovarian rupture [1].

2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


2021 ◽  
Vol 19 (4) ◽  
Author(s):  
I.A. Malishevsky

Purpose – to determine the statistical and epidemiological parameters of malignantneoplasms of the abdominal cavity organs.Material and methods. The study was carried out on the basis of the Chernivtsi RegionalClinical Oncological Dispensary and covers observation materials during 2019 andstatistical reporting concerning 21259 patients with tumors of various localization. The calculation of indices was carried out using software packages MS Access and MS Excelbased on the Microsoft Office medium.Results. Neoplasms of the abdominal organs account for 32.4%-37.1% of the totalnumber of neoplasms of various localization. The distribution of patients with malignantdiseases of the abdominal organs by developmental stages is relatively uniform, despitesignificant differences in various localizations of neoplasmsConclusions. Malignant neoplasms of the abdominal organs account for 32.4%(registered) and 37.1% of the newly diagnosed of the total number of tumors of variouslocalization, indicating the importance of further research. A significant part of tumors ofthe abdominal cavity organs are diagnosed in the late (III-IV) stages of the pathologicalprocess development (up to 94.7% in the liver and intrahepatic biliary tract). Therevealed significant differences in clinical and epidemiological characteristics requirefurther research.


2008 ◽  
Vol 28 (6) ◽  
pp. 641-647 ◽  
Author(s):  
Hirotaka Komatsu ◽  
Koichi Uchiyama ◽  
Masahiro Tsuchida ◽  
Naohito Isoyama ◽  
Masafumi Matsumura ◽  
...  

Objective Encapsulating peritoneal sclerosis (EPS) is a serious complication of continuous ambulatory peritoneal dialysis. Previous studies have created peritoneal sclerosis rat models using daily intraperitoneal injection of chlorhexidine gluconate (CG), but this technique is cumbersome and thickening of the peritoneum makes it difficult to evaluate the injection site. We therefore aimed to make a rat model using a continuous-infusion pump. Methods Various concentrations of CG (5%, 8%, 10%, 12%, and 14%) in ethanol were dissolved in saline within the infusion pumps, each of which was placed in the lower abdominal cavity of a male Wister rat. After a peritoneal equilibration test was performed, the rats were sacrificed and the lower anterior parietal and visceral peritoneum was removed. Each excised peritoneum was analyzed by macroscopic and microscopic examinations, including immunohistochemistry for the expression of transforming growth factor-beta 1 (TGF-β1), vascular endothelial growth factor (VEGF), and alpha-smooth muscle actin (αSMA). The results were compared with those of control rats injected with ethanol dissolved in saline within the infusion pump and with no-pump rats. Results Two of the 5 rats in the 12% CG group and 3 of the 5 rats in the 14% CG group died of ileus within 14 days. All the rats in the 5%, 8%, and 10% CG groups survived to 28 days. Macroscopic examination in the 10% CG group showed bowel dilatation, bowel adhesion, and bloody ascites, similar to those seen in human EPS patients. All rats in each CG group showed the same extent of thickening of the submesothelial compact zone, proliferation of collagen fibers, and presence of numerous cells and neovascularization. Within same CG groups, an equal degree of thickening was observed at all sites of the peritoneum. TGF-β1, VEGF, and αSMA were highly expressed in the peritoneum of the 10% CG group. Conclusion We developed a novel method of creating a peritoneal sclerosis rat model using a continuous-infusion pump. Our technique is simple and highly reproducible, and will be useful in the study of peritoneal sclerosis mechanisms.


2018 ◽  
Vol 16 (2) ◽  
pp. 56-58
Author(s):  
Unan Sultana ◽  
Md Qumrul Ahsan

Body stalk anomalies are a group of massively disfiguring abdominal wall defects in which the abdominal organs lie outside of the abdominal cavity in a sac of amnioperitoneum with absence of or very small umbilical cord. Various hypotheses proposed to explain the pathogenesis of limb body wall complex include early amnion disruptions, embryonic dysplasia, and vascular disruption in early pregnancy. Body stalk anomaly is an accepted fatal anomaly and, hence, its early diagnosis aids in proper management of the patient. We present a case of LBWC, exhibiting combined cranial, abdominal & limb features.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 56-58


2017 ◽  
Vol 10 (1) ◽  
pp. 58-62
Author(s):  
Tatyana M. Betova ◽  
Savelina L. Popovska ◽  
Radoslav G. Trifonov ◽  
Konstantina S. Karakadieva ◽  
Genoveva B. Valcheva ◽  
...  

SummaryDesmoid-type fibromatosis is a rare mesenchymal neoplasm with locally aggressive, infiltrating and destructive growth that is not characterized by a metastatic potential. According to their anatomical position, desmoid-type fibromatoses can be divided into three groups: extra-abdominal, intra-abdominal, and fibromatoses of the abdominal wall. Mesenteric fibromatoses account for 8% of the intra-abdominal ones. The latter are characterized by myofibroblastic proliferation and infiltration of both the pelvic and abdominal organs. We report a 26-year-old woman who complained of abdominal enlargement, feeling of heaviness, discomfort and reflux, which symptoms dated back 1-2 months prior to hospitalization. The patient underwent laparotomy due to subocclusive symptoms. Intraoperatively, a tumor sized 30 cm in diameter was found. The tumor originated from the mesentery and infiltrated in the jejunum, the entire ileum, and part of the caecum with perforation towards the abdominal cavity. The histological and immunohistochemical examinations are important for clarification of the diagnosis. The treatment requires a multidisciplinary approach, in which the surgical method has the key role.


1998 ◽  
Vol 32 (4) ◽  
pp. 407-413 ◽  
Author(s):  
Walter Zeller ◽  
Gabriele Meier ◽  
Kurt Bürki ◽  
Basile Panoussis

Tribromoethanol is widely used as an anaesthetic agent for embryo-transfer surgery for the generation of transgenic mice. Potential side effects such as local irritation, fibrous adhesions in the abdominal cavity, and mortalities of unknown cause have been reported. Mice of three different strains (CD-1, OF-1, NMRI) received intraperitoneal injections of pentobarbiturate (60 mg/kg, 0.4%), tribromoethanol (240 mg/kg, 1.2%), tribromoethanol (450 mg/kg, 2.5%), ketamine/xylazine (120 mg/kg, 1.2%/16 mg/kg, 0.16%) or saline (NaCl, 0.9%). After 24 h the animals were sacrificed and blinded histopathological examination of abdominal organs was performed by light microscopy. Tribromoethanol caused focal to diffuse necrosis primarily of subperitoneal muscle fibres of the abdominal wall, and, occasionally, necrotic changes on the surface of abdominal organs. These changes were associated with acute peritoneal inflammation and fibrinous serositis of the abdominal organs. The severity of the findings increased with the concentration of tribromoethanol. The use of ketamine/xylazine yielded a comparable success rate in embryo transfer without undesirable side effects. Further use of tribromoethanol is not recommended.


2016 ◽  
Vol 23 (3) ◽  
Author(s):  
M G Gonchar ◽  
A Ye Bogush ◽  
L D Pryymak

During the period of three years, 1,414 patients underwent laparoscopic surgery. 18 patients underwent diagnostic laparoscopy under local anaesthesia. All these patients in addition to the suspected pathology of the abdominal cavity were diagnosed with severe concomitant cardiopulmonary pathology including acute myocardial infarction, ischemic and hemorrhagic stroke, coma of various genesis, pneumonia. The proposed technique included a local anaesthesia around the navel, laparolifting, the insertion of a laparoscope and a short inspection (3-5 min) of the abdominal organs. Sometimes, especially in patients with hypertension, spinal or epidural anesthesia was used. While diagnosticating the pathology, if necessary, the anaesthesia was given, carboperitonium was applied and the necessary surgery was performed. 


2020 ◽  
Vol 48 (3) ◽  
pp. 85-90
Author(s):  
N. V. Shirinskaya ◽  
N. V. Kalyatina ◽  
A. V. Shirinskaya

Background. Gallbladder polyps have recently become more common in practice of general practitioners and gastroenterologists due to the improvement of instrumental imaging of the abdominal cavity. Aim of study: to analyze the dynamics of development of gallbladder polyps at an outpatient appointment of a general practitioner (gastroenterologist). Materials and methods. A prospective clinical five-year study of patients with gallbladder polyps was conducted. All patients underwent ultrasound examination of the abdominal organs (Voluson E10) once every six months during five years. Number and nature of the growth of polyps, size of the gallbladder, presence/absence of complaints, and burdened history of neoplastic diseases were evaluated in the dynamics of observation. Data obtained were subjected to standard statistical processing. Results. The study included 33 patients (14 men, 19 women aged 24–65 years, average age 45.19±1.73 yrs). In the initial ultrasound study, the number of visualized polyps varied from 1 to 5 (on average, 2.09±0.95), the size of the neoplasms ranged from 2 mm to 10 mm (on average, 5.75±1.10 mm). Burdened heredity in oncopathology was noted in 42.86% of men and 31.58% of women. Legless polyps were more often diagnosed in men (14.29%), while in women, polyps increased in size in the dynamics of observation >10 mm and a higher frequency of surgical interventions (cholecystectomy) were more often recorded. Conclusion. Gallbladder polyps tend to grow slowly. We outlined the questions facing the clinician in the management of patients with gallbladder polyps in terms of choosing the optimal tactic and surgical treatment due to the possible malignancy of these formations.


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