Infections of the GI Tract II: Management of Peritonitis

摘要

Inflammation of the mesothelial lining of the peritoneum is a relatively common event in horses. Primary peritonitis is rare-usually the condition is secondary to some other insult that introduces infection or incites inflammation in the relatively well-protected cavity. The aetiology and pathology of the inflammatory process and the cause for this are central to the treatment methods that can be applied. The condition is life threatening and requires emergency treatment in all cases if the horse isreturn to normal health. Some cases are immediately fatal (such as intestinal rupture) and these preclude any attempt at treatment-a rapid diagnosis and immediate euthanasia reduce suffering. Overall, the condition carries a mortality of over 60% and ofthe survivors over 50% have serious long-term complications such as adhesions and internal abscessation. The prognosis is critically dependent on the speed with which the diagnosis is made and the application of rational and aggressive therapy. The mainproblem is the speed of progression and the difficulty of diagnosis - any delay makes the prognosis much worse no matter how mild the condition is to start with. There are also considerable problems with therapy because the size and disposition of the abdominal viscera make it impossible to empty the abdomen and flush every single corner effectively. Peritonitis can be classified in terms of onset (peracute, acute, chronic) or the aetiology (see Table 1) or the distribution(localised / generalised) or the nature of the inflammation (sterile / septic)