Pathophysiology of Peritonitis
The initial reaction of peritoneum to invasion by bacteria is a discharge of exudate fibrinosa. Pockets of pus (abscess) formed between fibrinosa adhesions, which stick together with the surrounding surface and limit the infection. Attachment usually disappears when the infection disappeared, but may persist as fibrous bands, which later can lead to intestinal obstruction.
Cause inflammation and fluid accumulation due to capillary membrane leak. If the fluid deficit is not corrected quickly and aggressively, it can cause cell death. The release of various mediators, such as interleukins, could start hyperinflammatory response, thus bringing to the subsequent development of many organ failure. Because the body tries to compensate by way of fluid and electrolyte retention by the kidneys, waste products also accumulate. Tachycardia initially improve cardiac output, but it soon failed so happens hypovolemia.
Organs including the peritoneal cavity in the abdominal wall edema experienced. Edema caused by capillary permeability organs is rising. Collection of fluid in the peritoneal cavity, and intestinal lumen and lumen-whole organ edema, intra-peritoneal and abdominal wall edema, including the retroperitoneal tissue causing hypovolemia. Hypovolemia increases with the increase in temperature, there is no input, and vomiting.
Entrapped liquid in the peritoneal cavity and intestinal lumen, further increasing intra-abdominal pressures, making full efforts into breathing difficult and cause a decrease in perfusion.
If the material is spread to infect the peritoneal surface or if the infection spreads, general peritonitis may arise. With the development of general peritonitis, peristaltic activity is reduced to arise paralytic ileus; intestine then becomes Atoni and stretch. Lost fluids and electrolytes into the intestinal lumen, resulting in dehydration, shock, circulatory disorders and oliguria. Adhesions can form between the arches are stretched intestines and can interfere with the recovery of bowel movements and cause intestinal obstruction.
