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1、ACUTEABSCESSEPERITONITISAnatomyandPhysiologyofthePeritonealCavityTheperitonealcavityiscoveredbyasinglelayerofmesothelialcellsonconnectivetissue,includingcollagen,elasticfibers,macrophages,andfatcells.AnatomyandPhysiologyofthePeritonealCavityTheparietalperitoneum,w
2、hichcoverstheabdominalcavity,includingtheanteriorabdominalwall,diaphragm,andpelvis,isimmediatelyadjacenttoandreinforcedbythetransversalisfascia.Thevisceralperitoneumcoversalltheintraperitonealviscera,creatingacompletelyenclosedcavityexceptfortheopenendsofthefallop
3、iantubes.Theparietalperitoneumisinnervatedbybothsomaticandvisceralafferentnerves.Theperitoneumoftheanteriorabdominalwallistheareamostsensitivetostimuli,andthepelvicperitoneumisthearealeastsensitive.AnatomyandPhysiologyofthePeritonealCavityPatientswithabdominalpain
4、mayshowtendernesstopalpationoftheabdomen;andifperitonealirritationexists,theyhavereboundtenderness.Localizedinflammationoftheanteriorparietalperitoneummayleadtovoluntarymuscleguarding.Thevisceralperitoneumisrelativelyinsensitiveandreceivesafferentinnervationonlyfr
5、omtheautonomicnervoussystem.Stimulifromthevisceralperitoneumareoftenpoorlylocalizedandareperceivedasdullorintermittentcramping.AnatomyandPhysiologyofthePeritonealCavityThevisceralafferentnerveshavenoreceptorstomediatepainandtemperaturebutdorespondtodistention,trac
6、tion,andpressure.Thebiliarytractandmesenteryhavegreaterinnervationthanthesmallintestine.Thus,painfromthegallbladderandcommonductismoreaccuratelylocalizedthanthatfromthesmallintestine.AcuteGeneralizedPeritonitis1.Definition:Acuteabscessperitonitispervadedallperiton
7、ealcavityiscalledacutegeneralizedperitonitis(AGP).Peritonitis,classifiedasprimaryorspontaneousperitonitisandsecondaryperitonitis.2.EtiologySecondarydefuseperitonitis(themostcommon)①Acuteperforationofgastricandduodenalulcer②Gallbladderperforationfollowingacutechole
8、cystitis③Traumaticruptureofintestineandbladder④Severeacuteappendicitisandpancreatitis⑤AnastomoticleakagefollowingoperationPrimarydefuseperitonitis1.Thro
