Peritonitis

Peritonitis is known to be general or localized, acute or chronic, primary or secondary.

Acute general purulent peritonitis is believed to be due to perforation of one of the hollow abdominal organs. The most frequent causes are perforating appendicitis, inflammatory conditions of the female sex organs and perforating gastric or duodenal ulcers.

The main symptoms of this condition are vomiting, pain and tenderness in the abdomen, it being considerably enlarged due to the presence of fluid there. The temperature is known to be moderately elevated, the pulse rate being con­siderably changed. The blood analysis usually reveals leucocytosis.

This condition is extremely dangerous to the patient's life, an emergency surgery being performed to save the patient. During the operation the primary focus of peritonitis is to be removed, the danger for the patient being elimi­nated.

Emergency operative treatment is known to be followed by a course of antibiotic treatment, which greatly contributes to the recovery.

Types of examination of the patient.

A number of different procedures is used to establish a diagnosis: history-taking, physical examination, which includes visual examination, palpation, per¬cussion, auscultation, laboratory studies, consisting of urinalysis, blood, spu¬tum and other analyses; instrumental studies, for example, taking electrocar¬diograms or cystoscopy, X-ray examination and others.

For determining a disease it is very important to know its symptoms such as breathlessness, edema, cough, vomiting, fever, haemorrhage, headache and oth¬ers. Some of these symptoms are objective, for example, haemorrhage or vom¬iting, because they are determined by objective study, while others, such as headache or dizziness (головокружение) are subjective, since they are evident only to the patient.

Symptoms lobular pne.

Fever had been persisting for two weeks and had been decreasing gradually.

The patient's breathing was rapid with 30-40 respirations per minute. There was breathlessness and cyanosis of the face associated with the accompanying bronchitis, decrease in the respiratory surface and occlusion of numerous bron¬chioles and alveoli.

The patient complained of the pain in the chest particularly on deep breath¬ing in and cough ulent sputum. The pulse rate was accelerated and the arterial pressure.

The main signs rheumatic endoca.

The patient complained of a general malaise, early fatigue on exertion, car¬diac discomfort and palpitation.

The physician found him to have been having an increase of body tempera¬ture to a subfebrile level for a prolonged period of time. The patient stated that the onset of the disease had been preceded by tonsillitis. The patient's pulse rate had become irregular and accelerated on physical exertion.

The blood analysis revealed moderate leucocytosis and an elevated ESR. The electrocardiogram showed the changes in the most important readings. On percussion the doctor determined the heart to be slightly enlarged. These symptoms were accompanied by diastole murmur heard at the apex and base of the heart.