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Abdominal and Genitourinary Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Diagnostic peritoneal lavage is a diagnostic technique in which a catheter is passed into the abdominal cavity, a volume of warmed fluid is instilled and then drained to assess for blood or GI contents.30 CT has rendered this investigation of historical interest only under most circumstances.
Two Centimeter D1–2 Anterior Perforation Presenting 24 Hours Later
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Peritoneal lavage: Thorough peritoneal lavage (5–10 L of saline) is commonly practiced during surgery for perforation causing peritonitis in order to decrease the risk of infection despite the lack of evidence to support its use. We usually irrigate the peritoneal cavity to get rid of the solid debris and remove gross contamination.
Distribution and Toxicity of Retroviral Vectors after Intracavitary Delivery in Mouse and Man
Published in Eric Wickstrom, Clinical Trials of Genetic Therapy with Antisense DNA and DNA Vectors, 2020
Patrice S. Obermiller, Carlos L. Arteaga, Jeffrey T. Holt, Anne M. Pilaro
Slight traces of intraperitoneally injected LXSN-BRCA1 vector were found by PCR in the following tissues at the 4 hour time point: pancreas, spleen, liver, ovary and colon. Because intraperitoneal injection of LXSN-BRCAlsv produced peritonitis in the above preclinical studies, patients were carefully evaluated for clinical and laboratory signs of acute peritonitis. Three of the 12 patients developed peritonitis as evidenced by patient discomfort, fever, peritoneal fluid counts, and negative bacterial cultures, which resolved within 24-48 hours after treatment was stopped. No recurrence of peritonitis was observed, even after two additional dose escalations. Other toxicities included fever in four patients and nausea in two patients, presumably from abdominal distension produced by the intraperitoneal infusion of vector plus 1 liter of saline.
Effect of different dialysis duration on the prognosis of peritoneal dialysis-associated peritonitis: a single-center, retrospective study
Published in Renal Failure, 2023
Qichen Liang, Huiping Zhao, Bei Wu, Qingyu Niu, Lixia Lu, Jie Qiao, Chuncui Men, Yuting He, Xinxin Chu, Li Zuo, Mei Wang
Peritoneal dialysis (PD)-associated peritonitis is a common and serious complication of PD; it is the most common reason for PD discontinuation [1]. Severe or recurrent peritonitis can cause changes in the structure and function of the peritoneum. Besides causing decreased peritoneal ultrafiltration, malnutrition, increased volume overload, and hospitalization in patients, severe PD peritonitis leads to patients’ withdrawal from PD and being transferred to hemodialysis and even death. With the recent and continuous improvement of PD-related technologies (such as the twin-bag system) and patient management level, the incidence of PD peritonitis has decreased each year; however, there are still great differences among different countries and PD centers, and the pathogen of peritonitis also keeps changing [2]. With the extension of the survival time of PD patients, the clinical characteristics of PD peritonitis in patients with long PD duration are being noticed increasingly. In a previous study, the cutoff value was taken as 36 months for analyzing the clinical characteristics and treatment outcome of PD peritonitis in patients with long PD duration; the results showed that patients with PD peritonitis and longer PD duration had a higher risk of gram-negative bacteria infection and that longer PD duration was an independent risk factor for catheter removal and treatment failure of peritonitis [3].
Proteomic study of mesothelial and endothelial cross-talk: key lessons
Published in Expert Review of Proteomics, 2022
Juan Manuel Sacnun, Rebecca Herzog, Klaus Kratochwill
There is a plethora of proteomic studies investigating EC and even some secretome studies in combination with other cell types that could potentially be used to extrapolate effects on MC [121–123]. MC research, however, seems to be the limiting factor for discussing crosstalk between these two cell types. In the past, ECs were thought to be a relatively simple cell layer with barrier and transport function separating the systemic circulation from tissue, though today we understand the endothelium as a more complex system with a vast amount of different functions [20]. The same is true for the peritoneum, an organ long thought to have few functions but providing a surfactant cover for the inner organs of the abdominal cavity. Over the last years, this notion has changed, as it became increasingly clear that it is more complex than a simple serous membrane [3]. MCs are, for example, crucial for kidney replacement therapy with peritoneal dialysis, a therapy where – even though the endothelial cells are never in direct contact with the PD fluid – the submesothelial vasculature gets significantly more damaged than expected by uremia alone [124,125]. This vascular damage, in turn, may be the culprit for the increased prevalence of cardiovascular disease in patients on kidney replacement therapy, eventually resulting in increased mortality. This highlights the clinical relevance of this knowledge gap and the need of adequate research. The mesothelium is in contact with both microvascular and lymphatic vessels [126].
Advances in the pharmacological management of bacterial peritonitis
Published in Expert Opinion on Pharmacotherapy, 2021
Daniel Pörner, Sibylle Von Vietinghoff, Jacob Nattermann, Christian P Strassburg, Philipp Lutz
Bacterial peritonitis is classified as primary and secondary peritonitis according to its pathogenesis [2]. Primary peritonitis is caused by bacterial translocation into the peritoneal cavity without evident loss of peritoneal integrity and predominantly occurs in immunosuppressed patients or children. This form of peritonitis includes the spontaneous bacterial peritonitis (SBP) of the cirrhotic patient, the tuberculous peritonitis, the peritonitis related to Chlamydia trachomatis as seen in pelvic inflammatory disease (PID) and in a broader sense, the peritoneal dialysis-related peritonitis (PDrP) [3]. Secondary peritonitis is the most common form of peritonitis and results from an infectious intraabdominal source with loss of peritoneal integrity and often demands surgical consultation [4]. Secondary peritonitis and SBP are predominantly caused by bacteria that colonize the intestinal mucosa whereas in patients on peritoneal dialysis (PD), bacteria that colonize the skin are the predominantly encountered pathogens. Mortality in peritonitis is related to systemic inflammation and sepsis. Therefore, adequate and timely antibiotic therapy is one of the therapeutic cornerstones in any of these forms of bacterial peritonitis [5]. However, because the different forms of bacterial peritonitis result in microbiological heterogenicity, the antibiotic strategy varies strongly between the entities.