Signs of Peritoneal Irritation
Signs of peritoneal irritation normally occur if there is any pathological process in the abdominal cavity. They are characterized by pain or tenderness on palpation. The irritation can be marked or diffused.
Défense Musculaire (Muscle Guarding)
The musles of abdominal wall are contracted. It is a reflex response of an organism that is intended to prevent the spread of irritation. The patient´s abdominal wall palpation is very hard.
The palpation of place, which patient locates as problematic, is very painful.
You push the irritated place and then let your hands off quickly. The pain is caused by the release of pressure. Also, called rebound tenderness
This sign is the same as Blumberg, but you push the abdominal wall on the opposite site of the irritation.
Etiology of Peritonitis
- Perforation of a hollow organ with unsterile content (e.g.: small and large intestine) – ulcer perforation
- Inflammation (e.g. appendicitis, pancreatitis, cholecystitis, cholangitis)
- Spontaneous bacterial peritonitis
- Iatrogenic (e.g. complication of gastroscopy or colonoscopy)
- Open wound
- Perforation of a hollow organ, which contains sterile liquid (e.g. gastric juice, bile, urine...)
- Bleeding in abdominal cavity (trauma, rupture of parenchymatous organ – haemoperitoneum)
- Autoimmune inflammation (e.g. Lupus Erythematosus)
- Lupus Erythematodes
- Spontaneous Bacterial Peritonitis
- KLENER, Pavel, et al. Vnitřní lékařství. 4th edition. 2011. ISBN 978-80-7262-705-9.