General Pathology: Diseases of the Peritoneum & Gastrointestinal Vascularization PDF

GENERAL PATHOLOGY Diseases of the peritoneum and gastrointestinal vascularization Dr. Antonio Barrasa  Intended learning objectives To introduce to the clinical presentation of the patient with diseases of the peritoneum and intestinal vessels – Introduction to...

GENERAL PATHOLOGY Diseases of the peritoneum and gastrointestinal vascularization Dr. Antonio Barrasa  Intended learning objectives To introduce to the clinical presentation of the patient with diseases of the peritoneum and intestinal vessels – Introduction to pathophysiology of peritonitis – Introduction to pathophysiology of intestinal ischemia Dr. Antonio Barrasa Translinphatic absoprtion baterial clearance Respiratory movements cause a subdiafragmatic vacumm that drives peritoneal fluid. Absorbes up to 60% of the bacterial inoculum. Neutrophil phagocytosis Peritoneal cavity resident non mesotelial cells – 50% lymphocytes, 40% macrophages & 10% eosinophils Inflammatory response within 3-4 hours. Fagocyte 30% microorganisms. Fibrotic local compartimentalization Dr. Antonio Barrasa  Primary peritonitis – Spontaneous bacterial peritonitis – Peritoneal dialysis system infection – Primary peritonitis in children Secondary peritonitis – Local – Disseminated Tertiary peritonitis Dr. Antonio Barrasa  Symptomatology – PAIN – Fever, nausea & intestinal arrest – SIRS symptomatology Exploration – Muscular tenderness – Specific signs: Blumberg, Murphy, Rovsing Complementary studies – Blood tests – Cultures – Image studies Dr. Antonio Barrasa  Emboli Arterial Thombosis Occlusive Mesenteric ischemia Thormbosis Venous Acute Estrangulation Arterial Vasoconstriciton Non occlusive Vanous Chronic Atherosclerosis Dr. Antonio Barrasa