腹膜炎、腹腔脓肿课件

腹膜炎、腹腔脓肿课件

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时间:2018-10-07

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1、ACUTEABSCESSEPERITONITISAnatomyandPhysiologyofthePeritonealCavityTheperitonealcavityiscoveredbyasinglelayerofmesothelialcellsonconnectivetissue,includingcollagen,elasticfibers,macrophages,andfatcells.AnatomyandPhysiologyofthePeritonealCavityTheparietalperitoneu

2、m,whichcoverstheabdominalcavity,includingtheanteriorabdominalwall,diaphragm,andpelvis,isimmediatelyadjacenttoandreinforcedbythetransversalisfascia.Thevisceralperitoneumcoversalltheintraperitonealviscera,creatingacompletelyenclosedcavityexceptfortheopenendsofthe

3、fallopiantubes.Theparietalperitoneumisinnervatedbybothsomaticandvisceralafferentnerves.Theperitoneumoftheanteriorabdominalwallistheareamostsensitivetostimuli,andthepelvicperitoneumisthearealeastsensitive.AnatomyandPhysiologyofthePeritonealCavityPatientswithabdo

4、minalpainmayshowtendernesstopalpationoftheabdomen;andifperitonealirritationexists,theyhavereboundtenderness.Localizedinflammationoftheanteriorparietalperitoneummayleadtovoluntarymuscleguarding.Thevisceralperitoneumisrelativelyinsensitiveandreceivesafferentinner

5、vationonlyfromtheautonomicnervoussystem.Stimulifromthevisceralperitoneumareoftenpoorlylocalizedandareperceivedasdullorintermittentcramping.AnatomyandPhysiologyofthePeritonealCavityThevisceralafferentnerveshavenoreceptorstomediatepainandtemperaturebutdorespondto

6、distention,traction,andpressure.Thebiliarytractandmesenteryhavegreaterinnervationthanthesmallintestine.Thus,painfromthegallbladderandcommonductismoreaccuratelylocalizedthanthatfromthesmallintestine.AcuteGeneralizedPeritonitis1.Definition:Acuteabscessperitonitis

7、pervadedallperitonealcavityiscalledacutegeneralizedperitonitis(AGP).Peritonitis,classifiedasprimaryorspontaneousperitonitisandsecondaryperitonitis.2.EtiologySecondarydefuseperitonitis(themostcommon)①Acuteperforationofgastricandduodenalulcer②Gallbladderperforati

8、onfollowingacutecholecystitis③Traumaticruptureofintestineandbladder④Severeacuteappendicitisandpancreatitis⑤AnastomoticleakagefollowingoperationPrimarydefuseperitonitis1.Thro

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