When ascites develops rapidly, it is often accompanied by peritonitis. The puncture shows a bacterial infection of the ultrafiltrate, laboratory tests allow detecting the presence of the intestinal rod, Gram-positive bacteria, and Klebsiella pneumonia sticks.
For etiology, ascites-peritonitis is divided into two types of primary and secondary.
The diagnosis of primary ascites-peritonitis is made when the dropsy of the abdomen proceeds against a background of prolonged inflammation of the peritoneum in the absence of a source of infection in the form of a violation of the integrity of the membranes of internal organs. Secondary ascites-peritonitis becomes a formidable complication of acute appendicitis, pancreatitis, various abscesses, perforations of the intestine or stomach. Primary disease is extremely rare, in only 1% of cases, in others the described pathological condition is a consequence of serious diseases, so the predictions are not always comforting.
Reasons for ascites and perito
How can pathogenic microorganisms get into ascites fluid? There are several ways of infection.
- The hematogenous pathway is formed when there is a local infection center( bronchopulmonary, urogenital, tuberculosis, salmonellosis) inside the body.
- The lymphogenous pathway is the spread of infection through the lymphatic system. Uterine way( in women).Infection into the abdominal cavity enters through the fallopian tubes.
Not so long ago a new term "spontaneous ascites-peritonitis" appeared in medicine. In 1964, American scientist Harold Ohn described in detail the processes of infection of the peritoneum with cirrhosis, provoked by intestinal microorganisms. Spontaneous ascites-peritonitis develops quite rapidly in individuals with alcoholic cirrhosis of the liver. In this case, in 30% there is a lethal outcome. Such a complication can develop in the presence of gastrointestinal bleeding, increase in protein content in the liquid, serum ampulin and creatinine levels. In the risk group and those diagnosed with bacteremia, viremia, microcirculation disorders in the walls of the intestine, and also confirmed the reduced trophic status.
Today, spontaneous ascites-peritonitis occurs in 30% of cases, 50% is fatal, so it's important not to miss the moment, learn to recognize symptoms and get help from specialists in time.
How does ascites-peritonitis appear?
The disease has characteristic symptoms. This is:
- Severe fever.
- Septic shock.
- Strengthening the degree of hepatic insufficiency.
- Sharp deterioration of the patient.
- Presence of peritoneal signs( abdominal wall tension, Shchetkin symptom).
In the initial stages of the patient, severe pain in the lower abdomen, vomiting and diarrhea are concerned. An accurate diagnosis is assisted by puncture and laboratory examination of the fluid. Treatment of ascites-peritonitis begins before the answers of the diagnostic examination. And all because you can not delay. The most important thing is to eliminate the cause of the disease and suppress painful microorganisms. The nature of their birth will be explained by laboratory research, it will also tell what medication should be prescribed to the patient. As a rule, therapy is necessarily based on the use of antibiotics of different groups, antimicrobial drugs. The results of microbial sowing will help clarify and correct the already prescribed treatment.