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Zapalenie otrzewnej – przyczyny, objawy, leczenie

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Zapalenie otrzewnej to proces zapalny o zlokalizowanym lub rozlanym charakterze, który rozwija się w jamie otrzewnej w wyniku przedostania się do niej bakterii lub niezakażonego płynu ustrojowego. Przyczyną zapalenia otrzewnej mogą być zarówno choroby, jak i zabiegi chirurgiczne czy urazy brzucha. Jakie są objawy i jak przebiega leczenie?

Przyczyny zapalenia otrzewnej

Do zapalenia otrzewnej dochodzi na skutek zakażenia bakteryjnego lub podrażnienia spowodowanego przez niezakażony płyn ustrojowy (np. wynaczyniona krew, żółć, enzymy trzustkowe).

Do bezpośrednich przyczyn zapalenia otrzewnej zalicza się:

* perforację przewodu pokarmowego (w tym również perforację urazową),

* przemieszczenie bakterii do jamy otrzewnej bez perforacji na skutek zapalenia wyrostka robaczkowego, pęcherzyka żółciowego, trzustki, przydatków, uchyłków, wrzodziejącego zapalenia jelita grubego lub niedrożności jelit,

* przebicie ropnia (okołonerkowego, jajnikowo-jajowodowego, ropnia wątroby, śledziony lub ropnia w przebiegu choroby Leśniowskiego-Crohna) do jamy otrzewnej,

* urazy brzucha (zwłaszcza rany drążące),

* komplikacje i powikłania zabiegów operacyjnych ­ rozejście zespoleń pooperacyjnych, przerwanie ściany przewodu pokarmowego w wyniku nieprawidłowo przeprowadzonej kolonoskopii lub gastroskopii.

Objawy zapalenia otrzewnej

Wśród miejscowych objawów zapalenia otrzewnej wymienia się bolesność uciskową, zwiększone napięcie mięśni brzucha (obrona mięśniowa), objaw Blumberga (silny ból występujący w momencie gwałtownego zwolnienia ucisku wywieranego na powłoki brzuszne), a także „ciszę w brzuchu” (niedrożność porażenna).

Do objawów ogólnych zapalenia otrzewnej należą wzrost temperatury ciała, dreszcze, tachykardia, przyspieszenie i spłycenie oddechu, zatrzymanie gazów i stolca, nudności i wymioty.

Leczenie zapalenia otrzewnej

Leczenie odbywa się za pośrednictwem zabiegu operacyjnego, który ma na celu usunięcie ogniska zakażenia. W części przypadków po zabiegu pacjent wymaga drenażu jamy otrzewnej.

Dodatkowo wdraża się farmakoterapię z wykorzystaniem antybiotyków, leków przeciwkrzepliwych i przeciwbólowych.

W przypadku niepodjęcia odpowiednio szybkiego leczenia zapalenie otrzewnej stanowi bezpośrednie zagrożenie zdrowia i życia pacjenta.

Źródło: https://www.doz.pl/, https://www.medonet.pl/, http://chirurgia3.cm-uj.krakow.pl/

Przeczytaj także: Jak pandemia koronawirusa wpłynęła na opiekę nad pacjentami z cukrzycą?

Przeczytaj bezpłatnie pokrewny artykuł w czasopiśmie „Chirurgia Plastyczna i Oparzenia”:

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