복막염

소개

복막염에 대한 자세한 기술, 진단, 항생제 치료.
해리슨등 교과서 군데군데 기술되어있는 복막염을 총정리.

목차

Peritonitis
1. Acute peritonitis
2. spontaneous bacterial peritonitis
3. Tuberculous peritonitis
4. Peritonitis in continuous ambulatory peritoneal dialysis
5. Miscellaneous forms of peritonitis

본문내용

1. Acute peritonitis
- Definition : peritoneal cavity 내에서, bacteria나 intestinal contents (including gastric acid, gastrointestinal luminal contents, bile, or pancreatic juice) peritoneum 나 peritoneal fluid에 발생하는 급성 염증.

1) 원인
① infectious (bacterial) peritonitis : E. coli(m/c), appendix rupture, peptic ulcer, perforation, diverticula rupture, incarcerated hernia, gangrenous GB, intestinal obstruction, volvulus, bowel infaction, cancer, IBD, SBP(LC), CAPD peritonitis 등.
② aseptic peritonitis
* physiologic fluids (chemical peritonitis) : pancreatic enzymes, gastric acid, bile, blood, urine
* sterile foreign, bodies : 수술도구 등에 의함
* systemic disease의 complication : SLE, porphyria, familial Mediterranean fever

2) Prognostic Factors
- low mortality : 건강한 환자의 acute appendicitis, perforated peptic ulcer
- high mortality : after elective surgery, trauma, pancreatitis
- severe peritonitis의 outcome은 patient`s overall health, including nutritional status, immunocompetence, systemic factor(cardiac and renal function)에 따름.

참고자료

· - Cecil Textbook of Medicine 22nd edition
· - Harrison`s Principles of Internal Medicine 16th Edition
· - Recommendations for the treatment of lipid disorders in patients on peritoneal dialysis. ISPD guidelines/recommendations. International Society for Peritoneal Dialysis. : Peritoneal Dialysis International. 19(1):7-16, 1999 Jan-Feb.
· - 임상신장학 제 3판 : 김현철, 박성배 저.