A modern view of the causes and mechanisms of the development of acute disseminated peritonitis
Keywordsacute generalized peritonitis, classification of acute peritonitis, multiple organ failure, intra-abdominal hypertension, compartment syndrome
Despite the fact that the diagnosis of acute peritonitis has improved in recent years, a wide range of antibiotics is available, and minimally invasive methods of surgical treatment have been implemented, the mortality rate for this disease is high and ranges from 12.5 % to 39.2 %.
The purpose of the work was to analyze data from literary sources regarding the classification of acute peritonitis, to summarize the causes and mechanisms of its development among the adult population.
Analytical and bibliosemantic research methods were used in the work.
It is known that according to the nature of penetration of microflora into the abdominal cavity, peritonitis is divided into primary, secondary and tertiary. According to the clinical course, peritonitis is divided into acute, subacute and chronic. According to the nature of the exudate in the abdominal cavity, serous, serous-purulent, fibrinous, fibrinous-purulent, purulent, hemorrhagic, fecal and purulent peritonitis are distinguished. To date, the existing classifications are constantly being improved and have both practical and academic significance.
It has long been known that the cause of unsatisfactory results of surgical treatment of patients with acute disseminated peritonitis can be the development of intra-abdominal hypertension with subsequent development of compartment syndrome and multiple organ failure. The development of multiple organ failure is the leading cause of death in patients with acute surgical pathology. Abdominal compartment syndrome plays a big role in this, the mortality in which reaches very significant figures – 42-68 % and without treatment approaches 100 %.
Therefore, the development of acute peritonitis is due to numerous reasons (in particular, acute destructive appendicitis, cholecystitis, perforated ulcer of the stomach or duodenum, intestinal obstruction, tumor processes, gynecological pathology, abdominal injuries, etc.), which in turn causes the absence of a generally recognized justified classification.
Capobianco A, Cottone L, Monno A, Manfredi AA, Rovere-Querini. The peritoneum: healing, immunity, and diseases. P. J Pathol. 2017;243(2):137-147.
Ross JT, Matthay MA, Harris HW. Secondary peritonitis: principles of diagnosis and intervention. BMJ. 2018;361:k1407.
Pörner D, Von Vietinghoff S, Nattermann J, Strassburg CP, Lutz P.Advances in the pharmacological management of bacterial peritonitis. Expert Opin Pharmacother. 2021;22(12):1567-1578.
Li PK, Chow KM, Cho Y, Fan S, Figueiredo AE, [et al.]. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int. 2022;42(2):110-153.
Hervieux E. Acute peritonitis in children. Rev Prat. 2020;70(5):e177-e182.
Suzuki R, Sato M, Murakoshi M, Kamae C, Kanamori T, [et al.]. Eosinophilic peritonitis in children on chronic peritoneal dialysis. Pediatr Nephrol. 2021;36(6):1571-1577.
Kedra B. Acute peritonitis--current clinical classification. Przegl Lek. 1987;44(8):608-10.
Bassetti M, Eckmann C, Giacobbe DR, Sartelli M, Montravers P. Post-operative abdominal infections: epidemiology, operational definitions, and outcomes. Intensive Care Med. 2020;46(2):163-172.
Diaconescu B, Uranues S, Fingerhut A, Vartic M, Zago M, [et al.]. The Bucharest ESTES consensus statement on peritonitis. Eur J Trauma Emerg Surg. 2020;46(5):1005-1023.
Wittmann DH, Schein M, Condon RE. Management of secondary peritonitis. Ann Surg. 1996;224(1):10-8.
Capobianco A, Cottone L, Monno A, Manfredi AA, Rovere-Querini P. The peritoneum: healing, immunity, and diseases. J Pathol. 2017;243(2):137-147.
Montravers P, Assadi M, Gouel-Cheron A. Priorities in peritonitis. Curr Opin Crit Care. 2021;27(2):201-207.
Banno T, Shima H, Kawahara K, Okada K, Minakuchi J. Risk factors for peritoneal dialysis withdrawal due to peritoneal dialysis-related peritonitis. Nephrol Ther. 2021;17(2):108-113.
Unusual peritoneal dialysis fluid culture: Think secondary peritonitis. Cheema RS, Manandhar AK, Willis AP, David MD, Kamesh L. Perit Dial Int. 2021 Jan;41(1):127-128.
Biocompatible dialysis fluids for peritoneal dialysis. Htay H, Johnson DW, Wiggins KJ, Badve SV, Craig JC, Strippoli GF, Cho Y. Cochrane Database Syst Rev. 2018 Oct 26;10(10):CD007554.
Szeto CC, Li PK. Peritoneal Dialysis-Associated Peritonitis. Clin J Am Soc Nephrol. 2019;14(7):1100-1105.
Spalding DR, Williamson RC. Peritonitis. Br J Hosp Med (Lond). 2008;69(1):M12-5.
Culp WT, Holt DE. Septic peritonitis. Compend Contin Educ Vet. 2010;32(10):E1-14.
Lippi G, Danese E, Cervellin G, Montagnana M. Laboratory diagnostics of spontaneous bacterial peritonitis. Clin Chim Acta. 2014;430:164-70.
Germer CT, Eckmann C. Peritonitis. Chirurg. 2016;87(1):3-4.
Vega-Pérez A, Villarrubia LH, Godio C, Gutiérrez-González A, Feo-Lucas L, [et al.]. Resident macrophage-dependent immune cell scaffolds drive anti-bacterial defense in the peritoneal cavity. Immunity. 2021;54(11):2578-2594.e5.
Stocker F, Reim D, Hartmann D, Novotny A, Friess H. Clinical Manifestations and Therapeutic Implications of Peritonitis. Ther Umsch. 2020;77(4):171-176.
Simonyan KS. Peritonitis. М.: Medicine. 1971: 296 pp.
Gostischev VК, Sashyn VP, Avdovenko AL. Peritonitis. М.: Мedicine. 2002:224 pp.
Primary bacterial peritonitis in dogs and cats: 24 cases (1990-2006). Culp WT, Zeldis TE, Reese MS, Drobatz KJ. J Am Vet Med Assoc. 2009 Apr 1;234(7):906-13.
Pathophysiological changes in peritonitis. Delibegovic S. Med Arh. 2007;61(2):109-13.
Song DS. Spontaneous Bacterial Peritonitis. Korean J Gastroenterol. 2018;72(2):56-63.
Dever JB, Sheikh MY. Review article: spontaneous bacterial peritonitis -bacteriology, diagnosis, treatment, risk factors and prevention. Aliment Pharmacol Ther. 2015;41(11):1116-31.
Velkey B, Vitális E, Vitális Z. Spontaneous bacterial peritonitis. Orv Hetil. 2017;158(2):50-57.
Töns C, Schachtrupp A, Rau M, Mumme T, Schumpelick V. Abdominal compartment syndrome: prevention and treatment. Chirurg. 2000;71(8):918-26.
Surace A, Ferrarese A, Marola S, Cumbo J, Valentina G, [et at.]. Abdominal compartment syndrome and open abdomen management with negative pressure devices. Ann Ital Chir. 2015;86(1):46-50.
Dietz UA, Baur J, Piso RJ, Willms A, Schwab R, [et al.]. Laparostoma-Avoidance and treatment of complications. Chirurg. 2021;92(3):283-296.
Perova-Sharonova VM, Albokrinov AA, Fesenko UA, Gutor TG. Effect of intraabdominal hypertension on splanchnic blood flow in children with appendicular peritonitis. J Anaesthesiol Clin Pharmacol. 2021;37(3):360-365.
Sakka SG. The patient with intra-abdominal hypertension. Anasthesiol Intensivmed Notfallmed Schmerzther. 2016;51(1):8-16.
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