Modern medicine gives its answer to the question of what is peritonitis. This disease, characterized by inflammation of the sheets of the peritoneum, is presented in the form of stress, which is formed under the influence of several factors:
- endogenous (infection, inflammation);
- exogenous (anesthesia, surgical trauma);
- depressive effect 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 inflammation of the peritoneum occurs in about 80% of cases in inflammatory and destructive diseases of the abdominal cavity. Most often, these are local infectious and inflammatory processes of the abdominal esophagus, different parts of the stomach, duodenum, small and large intestines, appendix, liver, pancreas, biliary tract, and pelvic organs. A special group is made up of peritonitis with closed injuries and wounds of the abdominal organs, as well as those developed as a result of postoperative complications (iatrogenic injuries of internal organs,anastomotic failure). The image below shows peritonitis (photo).
Scientists continue to study the problem of peritonitis, as the average mortality rate remains quite high (20-30%) and reaches 40-50% in severe cases, such as postoperative peritonitis. Only by answering the question of what is peritonitis, you can find effective ways to eliminate this problem.
In 2000, VS 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 hollow organs as a result of spontaneous introduction of infection with blood into the abdominal integument or by the transfer of a specific infection from another organ (for example, tuberculous peritonitis, spontaneous peritonitis). Accounts for 1-5% of cases.
- Secondary peritonitis. Occurs most often. It is represented by several varieties: postoperative, post-traumatic - due to destruction or perforation of the abdominal organs. It develops as a local protective reaction of the body to infection.
- Tertiary peritonitis. The most severe form in terms of diagnosis and treatment, occurring with the development of the so-called persistent or recurrent peritonitis. It develops after operations, injuries, extreme situations, accompanied by a pronounced suppression of antimicrobial defense mechanisms. ATin this case, inflammation is caused by microflora that survived the first cycle of antibiotic treatment.
Features of the clinical course and the choice of treatment tactics are largely determined by the pathological contents of the abdominal cavity, on the basis of which a classification was created with the following forms of peritonitis:
- fecal;
- bilious;
- hemorrhagic;
- chemical.
The following types are distinguished by the nature of the exudate:
- serous-fibrinous (serous) peritonitis;
- fibrinous-purulent;
- purulent.
The study of peritonitis continues in order to develop a differentiated treatment strategy. The choice of classification principles is complicated by the fact that peritoneal inflammation is a multifactorial process. However, the development of a classification that can reflect the severity of common symptoms and formulate a reliable prognosis continues.
