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1、ACUTEABSCESSEPERITONITISAnatomyandPhysiologyofthePeritonealCavityTheperitonealcavityiscoveredbyasinglelayerofmesothelialcellsonconnectivetissue,includingcollagen,elasticfibers,macrophages,andfatcells.1AnatomyandPhysiologyofthePeritonealCavityTheparietalper
2、itoneum,whichcoverstheabdominalcavity,includingtheanteriorabdominalwall,diaphragm,andpelvis,isimmediatelyadjacenttoandreinforcedbythetransversalisfascia.Thevisceralperitoneumcoversalltheintraperitonealviscera,creatingacompletelyenclosedcavityexceptfortheop
3、enendsofthefallopiantubes.Theparietalperitoneumisinnervatedbybothsomaticandvisceralafferentnerves.Theperitoneumoftheanteriorabdominalwallistheareamostsensitivetostimuli,andthepelvicperitoneumisthearealeastsensitive.2AnatomyandPhysiologyofthePeritonealCavit
4、yPatientswithabdominalpainmayshowtendernesstopalpationoftheabdomen;andifperitonealirritationexists,theyhavereboundtenderness.Localizedinflammationoftheanteriorparietalperitoneummayleadtovoluntarymuscleguarding.Thevisceralperitoneumisrelativelyinsensitivean
5、dreceivesafferentinnervationonlyfromtheautonomicnervoussystem.Stimulifromthevisceralperitoneumareoftenpoorlylocalizedandareperceivedasdullorintermittentcramping.3AnatomyandPhysiologyofthePeritonealCavityThevisceralafferentnerveshavenoreceptorstomediatepain
6、andtemperaturebutdorespondtodistention,traction,andpressure.Thebiliarytractandmesenteryhavegreaterinnervationthanthesmallintestine.Thus,painfromthegallbladderandcommonductismoreaccuratelylocalizedthanthatfromthesmallintestine.4AcuteGeneralizedPeritonitis1.
7、Definition:Acuteabscessperitonitispervadedallperitonealcavityiscalledacutegeneralizedperitonitis(AGP).Peritonitis,classifiedasprimaryorspontaneousperitonitisandsecondaryperitonitis.2.EtiologySecondarydefuseperitonitis(themostcommon)①Acuteperforationofgastr
8、icandduodenalulcer②Gallbladderperforationfollowingacutecholecystitis③Traumaticruptureofintestineandbladder④Severeacuteappendicitisandpancreatitis⑤Anastomoticleakagefollowingoperation5Primarydefuseperitonitis1
