Peritonitis: Dr. Iwan Budiman, SP.B

You might also like

Download as ppt, pdf, or txt
Download as ppt, pdf, or txt
You are on page 1of 16

PERITONITIS

Dr. IWAN BUDIMAN, sp.B


SUBAGIAN BEDAH /RSUD. Sumbawa

PERITONITIS :
- Infeksi di rongga abdomen :
- E/:
- Perdarahan
- pus
- cairan bebas infeksi
- feses
- infeksi bakter ,TBCusus

PERITONITIS :
- Infeksi di rongga abdomen dan
inflamasi sbg reaksi di abdomen
- E/:
- Perforasi
- imflamatory
- Infeksi
- Inschemic injury
- perdarahan
3

- Secondary Peritonitis :
- Bactirial Contamination,
from : - viscera
- external (eg. Penetrating
injury)
- Primary Peritonitis
- Hemotogenous
- Transluminal/direct bacterial invasion
of Peritoneal Cavity

Common Causes of Peritonitis :


Severity
MILD

Cause
-Appendicitis
-Pertorated Gastroduodenal
ulcers
-Acute Salpingitis

MODERATE -Diverticulosis
-Nonvascular small bowel
pertoration
-Gangrenous Cholecystitis
-Multiple trauma
SEVERE

-Large bowel pertorations


-Ischemic small bowel perforation
-Acute necrotizing pancreatitis
-Post operative complication

Mortality
Rate
< 10 %

< 20 %

20-80 %

DIAGNOSTIC :
A. Simptom( keluhan) dan gejala :
* Clinical manafestation :
- demam
- nyeri dan perut membesar.
- MUNTAH HIJAU
- flatus(-) , BAB(-)
- Age
- General Health
* Pemeriksaan fisik utk melihat :
Adakah riwayat trauma
abdomen
6

* gejala local pada abdomen :


- nyeri seluruh abdomen
- Tenderness
- Distention
- Bising usus menghilang
- cairan / udara bebas di
rongga abdomen

Gejala sistemik :
- Fever
- Tachycardia
- mual , muntah
- Tachypnea
- Dehydration
- Oliguria
- Shock

Laboratory :
- Darah lengkap
- Elektrolyte
- Blood Clotting
- Liver and renal function test
- Sample for culture (blood, urine,
sputum, peritoneal fluid)

X. Ray :
- BOF
- Left lateral decubitus

10

TREATMENT:

O P E R A S I ( LAPAROTOMY )

11

12

TREATMENT:
A. Preoperative Care
- intravenous Fluid ( cairan IV)
- Antibiotics
B. Operative Management ( Laparotomy)
- Control sepsis
- Peritoneal lavage ( cuci rongga
abdomen)
- Peritoneal drainage
- Management of abdominal
distention
13

c. Post operative Care :


- Intensive care monitoring
- stabilkan hemodynamic
- Antibiotics (10-14 days)

14

COMPLICATIONS :
Local :
- infections dari seluruh usus
- Intraperitoneal sepsis
- gangguan anatomy usus
- Fistula abdomen
Systemic :
- Uncontrolled sepsis MODS
MOF

15

TERIMA KASIH

16

You might also like