eMentorSurgery

Dear students, Thisis only for your revision and NOT A FULL TEXT.

TUBERCULOUS PERITONITIS

•TYPES

•ACUTE AND CHRONIC

•CHRONIC-ASCITIC, FIBROUS, ENCYSTED, PURULENT

ACUTE

•VERY RARE TYPE

•MIMICS ACUTE PERITONITIS

•WHEN LAPAROTOMY IS DONE STRAW COLORED FLUID ESCAPES

•TUBERCLES ARE SEEN OVER PERITONEUM AND GREATER OMENTUM

•EARLY PHASES TUBERCLES AREGRAYISH AND TRANSLUCENT.

•UNDERGO CASEATION AND APPEAR YELLOWISH OR WHITE

•DIAGNOSISI   BY OMENTAL BIOPSY

CHRONIC

•HAS CONSIDERABLY DECLINED WITH THE PRACTICE OF PASTEURIZING ,MILK AND AVAILABILITY OF  VACCINATION AND NEWER ANTI TUBERCULOSIS CHEMOTHERAPY.

•COMMON SYMPTOMS-

•PAIN ABDOMEN

•FEVER

•LOSS OF WEIGHT

•NIGHT SWEATS

•MASS ABDOMEN

•TUBERCULOSIS FROM MESENTERIC NODES

•ILEOCAECAL TUBERCULOSIS

•TUBERCULOUS PYOSALPHINX

•MILIARY TUBERCULOSIS VIA BLOOD STREAM

•FROM PRIMARY FOCUS IN THE LUNG

ASCITIC TYPE

•PATHOLOGY

•PERITONEUM IS STUDDED WITH TUBERCLES

•PALE STRAW COLORED FLUID.

•INSIDIOUS ONSET

•LOSS OF APPETITE AND LOSS OF WEIGHT

•PALLOR

•ABDOMINAL DISTENSION-CHRONIC

•CONSTIPATION

•DIARRHEA

•ABDOMINAL WALL HAS DILATEDVEINS

•FLANKS ARE DULL AND THIS DULLNESS CAN BE SHIFTED

•MASS MAY BE PALPATED – ROLLED UP OMENTUM STUDDED WITH TUBERCLES

•MANTOUX TEST IS POSITIVE

•LAPAROSCOPY

•AREAS OF CASEATION ARE BIOPSIED

•CHEST X-RAY

•ASCITIC TAP- HIGH SPECIFIC GRAVITY, CAN BE CULTURED AND GUINEA PIG INOCULATION

ENCYSTED TYPE

•LIMITED AND LOCULATED TO ONE QUADRANT

•ENCAPSULATED COLLECTION OF FLUID

•DIFFERENTIAL  DIAGNOSIS-OVARIAN CYST, MESENTERIC CYST

•CAN CAUSE INTESTINAL OBSTRUCTION

•INVESTIGATIONIS SIMILAR TO ASCITIC

FIBROUS FORM

•MULTIPLE ADHESIONS

•BLIND LOOPSYNDROME- DIARRHEA, STEATORRHEA, WEIGHT LOSS , VIT B DEFICIENCY, INTESTINALOBSTRUCTION

•MULTIPLE PALPABLE SWELLINGS

•TREATMENT SURGICAL IS  ADHESIONOLYSIS, RESECTION OF BLIND LOOP

PURULENT FORM

•FROM FALLOPIAN TUBES

•CASEATION OF MESENTERIC LYMPH NODES

•COLD ABSCESS OR ABSCESSES

•CAN CAUSE OBSTRUCTION

•CAN BURST INTO BOWEL

•FAECAL FISTULA CAN OCCUR

CARCINOMA PERITONEI

•PERITONEUM IS STUDDED WITH MULTIPLE DEPOSITS OF SECONDARY CANCER

•ASCITIC FLIUD WIHICH IS STRW COLORED OR BLOOD STAINED

•NODULES

•PLAQUES

•ADHESIONS

•FROZENPELVIS

•TRANS COELOMIC SPREAD

•IMPLANTATION

•DAIGNOSIS IS BY ASCIIC FLUID ANALYSIS AND FOR A PRIMARY CAUSE

•TREATMENT IS  SYSTEMIC CHEMOTHERAPY

•INTRAPERITONEALI NSTILLATION OF CHEMOTHERAPEUTIC AGENTS

•TAMOXIFENIN BREAST CANCER

PSEUDO MYXOMA PERITONEI

•RARE

•FEMALES

•YELLOW JELLY MATERIAL

•MUCINOUS CYSTADENOCARCINOMA OVARY

•APPENDIX

•PAINLESS

•NO CLINICAL FETAURES FORLONG TIME

•LAPROTOMY AND SCOOP OUT THEMATERIAL AND SEND FOR ANALYSIS

•INTRAPERITONEALCHEMOTHERAPY HELPS