Common Causes of Peritonitis in the HorseAndrew J. Dart,
Hannah-Sophie Chapman, in Robinson's Current Therapy in Equine Medicine
(Seventh Edition), 2015Anatomy and PhysiologyThe peritoneum is a single layer
of squamous mesothelial cells resting on a loose connective tissue containing
blood vessels, lymphatics, and nerves. Anatomically, the peritoneum is divided
into a parietal and visceral peritoneum. The parietal peritoneum lines the
diaphragm, abdominal walls, and pelvic cavity. The parietal peritoneum is
continuous with the visceral peritoneum, which encloses the intraperitoneal
organs and forms the omentum and mesenteries of the abdominal cavities. A small
volume of peritoneal fluid lubricates the surface of the visceral and parietal peritoneum.
Together the peritoneum and fluid are responsible for preventing adhesion
formation. Normal peritoneal fluid is a transparent straw-colored ultrafiltrate
of plasma with a total protein (TP) concentration of less than 1.5 g/dL
(15 g/L) and total nucleated cell count (TNCC) of less than 2000 cells/µL (2 ×
109 cells/L). The distribution and consistent turnover of peritoneal fluid
ensures a highly effective clearance mechanism for bacteria, cells, and foreign
material entering the peritoneal cavity. Neutrophils represent 24% to 60% of
the cells found in peritoneal fluid. Protein concentrations greater than 2.0 to
2.5 mg/dL (20 to 25 g/L) and TNCCs greater than 5000 to10,000 cells/µL (5 to 10
× 109 cells/L) are considered abnormal.Read full chapter
An active intraabdominal drain has been used successfully to treat abdominal
contamination in horses. Closed-suction abdominal drains were placed, mostly
under general anesthesia. Abdominal lavage was done every 4 to 12 hours, and
about 83% of the peritoneal lavage solution was retrieved.
Edmund S. Cibas, in Cytology (Third Edition), 2009Peritoneal washing cytology
(PWC) was introduced in the 1950s as a way to identify microscopic spread of
cancer not visible by gross inspection of the peritoneal surface.1 In some
cancer patients, positive PWC may be the only evidence of metastatic disease to
the peritoneum. Because positive results correlate with a poorer prognosis,2,3
cytologic findings are included in the staging systems for ovarian,4 fallopian
tube,5 and endometrial cancers.6 The yield, however, is low; positive washings
by themselves change the surgical stage of only 3% to 5% of women with gynecologic
cancers.7,8
The peritoneum is the serous membrane that forms the lining of the abdominal
cavity or coelom in amniotes and some invertebrates, such as annelids. It
covers most of the intra-abdominal (or coelomic) organs, and is composed of a
layer of mesothelium supported by a thin layer of connective tissue. This
peritoneal lining of the cavity supports many of the abdominal organs and
serves as a conduit for their blood vessels, lymphatic vessels, and nerves.
Three trials involving 889 women were analysed. There was an increase in
adhesion formation (two trials involving 157 women, RR 2.49, 95% CI 1.49 to
4.16) which was limited to one trial with high risk of bias.There was reduction
in operative time, postoperative days in hospital and wound infection. There
was no significant reduction in postoperative pyrexia.
Peritoneal cancer is a rare cancer. It develops in a thin layer of tissue that
lines the abdomen. It also covers the uterus, bladder, and rectum. Made of
epithelial cells, this structure is called the peritoneum. It produces a fluid
that helps organs move smoothly inside the abdomen. Peritoneal cancer is not
the same as intestinal or stomach cancer. Nor is it to be confused with cancers
that spread (metastasize) to the peritoneum. Peritoneal cancer starts in the
peritoneum, and hence is called primary peritoneal cancer. The Link Between
Peritoneal and Ovarian Cancers Peritoneal cancer acts and looks like ovarian
cancer. This is mainly because the surface of the ovaries is made of epithelial
cells, as is the peritoneum. Therefore, peritoneal cancer and a type of ovarian
cancer cause similar symptoms. Doctors also treat them in much the same way.
Despite its similarities with ovarian cancer, you can have peritoneal cancer
even if your ovaries have been removed. Peritoneal cancer can occur anywhere in
the abdominal space. It affects the surface of organs contained inside the
peritoneum. The causes of peritoneal cancer are unknown. However, there are
different theories about how it begins. Some believe it comes from ovarian
tissue implants left in the abdomen during fetal development. Others think the
peritoneum undergoes changes that make it more like the ovaries. Risks of
Peritoneal Cancer Primary peritoneal cancer is more common in women than in
men. Women at risk for ovarian cancer are also at increased risk for peritoneal
cancer. This is even more likely if you have the BRCA1 and BRCA2 genetic
mutations. Older age is another risk factor for peritoneal cancer. Peritoneal
Cancer Symptoms Just as with ovarian cancer, peritoneal cancer can be hard to
detect in the early stages. That's because its symptoms are vague and hard to
pinpoint. When clear symptoms do occur, the disease has often progressed. Then,
symptoms resemble those of ovarian cancer. Many of these symptoms are due to
buildup of fluid (ascites) in the abdomen. Peritoneal cancer symptoms may
include: Abdominal discomfort or pain from gas, indigestion, pressure,
swelling, bloating, or cramps Feeling of fullness, even after a light meal
Nausea or diarrhea Constipation Frequent urination Loss of appetite Unexplained
weight gain or loss Abnormal vaginal bleeding Rectal bleeding Shortness of
breath
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