Surgical treatment of peritonitis

Peritonitis is an acute inflammatory lesion of the peritoneum, accompanied by severe intoxication of the body and rapid disruption of the functioning of vital organs. Peritonitis is an emergency condition that poses an immediate threat to life and requires urgent medical care. The disease progresses rapidly, and even a slight delay in treatment significantly increases the risk of severe complications, including sepsis and multiple organ failure.

In most cases, inflammation of the peritoneum cannot be eliminated by medication alone. The basis of effective treatment is timely surgical intervention aimed at eliminating the source of infection, sanitizing the abdominal cavity, and stabilizing the patient’s general condition.

At the «Oxford Medical» clinic in Kyiv, surgical treatment of peritonitis is carried out in a 24-hour surgical inpatient facility with an intensive care unit. We employ surgeons of the highest category with many years of experience, and the inpatient department is equipped with modern diagnostic and operating equipment of expert class.

Peritonitis develops as a result of infection or aggressive substances entering the abdominal cavity with subsequent development of an inflammatory process in the peritoneum. In most cases, the disease is a complication of other pathologies of the abdominal organs.

The main causes of peritonitis include:

• perforation or rupture of internal organs, in particular in acute appendicitis, perforated gastric or duodenal ulcer, intestinal obstruction, necrosis of the intestinal wall, severe forms of pancreatitis;
• spread of infection from the abdominal cavity or pelvic organs, in particular in gynecological diseases with the development of pelvioperitonitis;
• spontaneous bacterial peritonitis, which may occur in patients with liver cirrhosis and ascites without an obvious source of perforation;
• postoperative complications associated with suture failure, infection of the surgical wound, or a complicated course of the recovery period, leading to the development of postoperative peritonitis;
• dialysis-related peritonitis as a complication of peritoneal dialysis;
• closed and open abdominal injuries, internal bleeding, rupture of abscesses;
• entry of bile, blood, gastric or intestinal contents into the abdominal cavity.

In all of these cases, conditions are created for the rapid spread of infection and the development of severe inflammation of the peritoneum.

Peritonitis during pregnancy has a number of clinical features that complicate timely diagnosis. In the early stages of the disease, symptoms may be atypical or mild due to physiological changes in the woman’s body, especially in late pregnancy.

Abdominal pain is often masked as obstetric or gastroenterological complaints, and tension of the abdominal wall muscles may be insufficiently expressed. As the inflammatory process progresses, the condition of the pregnant woman worsens, signs of general intoxication and hemodynamic disorders appear, creating risks for both the woman and the fetus.

Treatment tactics are determined individually, taking into account the gestational age and the severity of the patient’s condition. In most cases, peritonitis during pregnancy requires urgent surgical intervention, which is performed with the participation of a multidisciplinary team of doctors. Timely seeking medical care is a key factor in reducing the risk of complications.

At the first stage, the doctor performs a clinical examination of the patient. The general condition, nature of abdominal pain, presence of tension of the abdominal wall muscles, blood pressure, heart rate, and body temperature are assessed. Analysis of complaints and the dynamics of their development is of great importance.

Laboratory diagnostics allow assessment of the severity of the inflammatory process and intoxication. Usually prescribed:

• complete blood count to detect leukocytosis and a shift in the leukocyte formula;
• biochemical blood test to assess liver and kidney function and water-electrolyte balance;
• urinalysis to monitor kidney function and the general condition of the body.

Instrumental examination methods make it possible to clarify the localization and cause of the pathological process. Depending on the clinical situation, the following may be used:

• ultrasound examination of the abdominal organs to detect free fluid, abscesses, or signs of perforation;
• abdominal radiography to determine free gas or fluid levels;
• computed tomography, which is one of the most informative methods for diagnosing peritonitis and its causes.

In complex or doubtful cases, endoscopy or diagnostic laparoscopy may be used. It allows direct assessment of the condition of the peritoneum, clarification of the source of inflammation, and, if necessary, immediate transition to surgical treatment.

Treatment of peritonitis is carried out in an inpatient setting and requires a comprehensive approach. Tactics are determined by the severity of the patient’s condition, the stage of the disease, the cause of inflammation, and the presence of concomitant pathologies. The main goal of treatment is to stop the inflammatory process, eliminate the source of infection, and prevent the development of complications.

Conservative therapy is a preparatory and supportive stage of treatment. It includes intensive infusion therapy to correct water-electrolyte disorders and reduce intoxication, broad-spectrum antibacterial treatment, as well as measures to stabilize blood pressure and the functions of vital organs. Drug therapy allows temporary stabilization of the patient’s condition, however, in most cases it cannot completely eliminate the cause of peritonitis.

An important component of treatment is monitoring the patient’s condition. Hemodynamic parameters, diuresis, laboratory markers of inflammation, and internal organ function are constantly monitored. If necessary, treatment of concomitant complications is carried out, including respiratory or renal failure.

In case of disease progression or the presence of a source of infection in the abdominal cavity, conservative methods are not sufficient. In such situations, surgical intervention becomes the main and decisive stage of treatment.

The «Oxford Medical» surgical inpatient facility is equipped with modern diagnostic and operating equipment of expert class. Surgical interventions are performed by surgeons of the highest category with many years of practical experience, ensuring a high level of safety and treatment effectiveness even in complex emergency cases.

After surgery, patients are transferred to single or double hotel-type rooms, where they remain under constant supervision of medical staff. This makes it possible to ensure comfortable conditions of stay, timely monitoring of the patient’s condition, and prompt response to any changes in well-being.

In the postoperative period, patients are advised to:

• adhere to the regimen prescribed by the doctor in the first days after surgery;
• regularly take prescribed medications;
• gradually restore physical activity in accordance with the doctor’s recommendations;
• follow the prescribed dietary regimen with gradual expansion of the diet;
• carefully monitor the condition of the postoperative wound and inform the doctor of any changes or discomfort;
• avoid physical exertion and lifting heavy objects until complete recovery;
• attend follow-up examinations at the times specified by the doctor.

Compliance with recommendations in the postoperative period is an important condition for safe recovery, reducing the risk of complications, and returning to a normal lifestyle.

The cost of surgical treatment of peritonitis depends on:

• the chosen method of surgical intervention — laparoscopic or open access;
• the scope of necessary postoperative treatment and inpatient stay.

You can preliminarily review the prices for surgical interventions at the «Oxford Medical» clinic here. A more accurate cost of treatment can be determined by the doctor after examining the patient and conducting diagnostics.