How is acute peritonitis treated?

In general, acute peritonitis may be caused by abdominal trauma, consumption of contaminated food, perforation of acute appendicitis, perforated gastric or duodenal ulcers, or perforated acute cholecystitis. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general treatment, medication, surgical intervention, etc. Specific analyses are as follows:

1. Abdominal Trauma: Blunt or penetrating injuries to the abdomen can damage internal organs, allowing bacteria to enter and trigger inflammation. Immediate bed rest is required, with avoidance of strenuous activity. Antibiotics such as ceftriaxone sodium injection, metronidazole injection, and levofloxacin injection should be administered according to medical advice to prevent infection. If organ rupture occurs, exploratory laparotomy is necessary to repair the damaged organs.

2. Contaminated Diet: Consuming food contaminated with bacteria allows pathogens to enter the abdominal cavity via the digestive tract, triggering acute peritonitis, often accompanied by symptoms such as abdominal pain and vomiting. Temporary fasting and fluid restriction are needed, with intravenous fluids used to maintain nutrition. According to medical guidance, antibiotics such as amoxicillin-clavulanate potassium injection, cefoperazone-sulbactam sodium injection, and norfloxacin capsules should be used to eliminate the bacterial infection.

3. Perforated Acute Appendicitis: If acute appendicitis is not treated promptly, necrosis and perforation of the appendix wall can occur, allowing pus to leak into the abdominal cavity and cause peritonitis. The abdominal pain is severe and progressively spreads. Emergency laparoscopic appendectomy should be performed to remove the diseased appendix. Postoperatively, antibiotics such as ceftazidime injection, metronidazole injection, and clindamycin phosphate injection should be used as directed to control infection.

4. Perforated Gastric or Duodenal Ulcer: When an ulcer erodes through the wall of the stomach or duodenum, gastrointestinal contents leak into the abdominal cavity, irritating the peritoneum and causing acute peritonitis, typically associated with severe upper abdominal pain. Prompt surgical repair of the perforation (gastric or duodenal perforation repair) is required. During the postoperative fasting period, nutrition should be provided intravenously. Medications such as omeprazole sodium injection, lansoprazole enteric-coated tablets, and pantoprazole sodium enteric-coated tablets should be used as prescribed to suppress gastric acid secretion.

5. Perforated Acute Cholecystitis: Acute inflammation of the gallbladder caused by gallstones or infection can lead to rupture and perforation of the gallbladder wall, allowing bile to leak into the abdominal cavity and cause peritonitis, with prominent pain in the right upper quadrant. Timely cholecystectomy is required to remove the diseased gallbladder. Postoperatively, antibiotics such as cefotaxime sodium injection and metronidazole injection, along with ursodeoxycholic acid capsules to promote bile excretion, should be administered as directed.

During treatment, vital signs should be closely monitored. The environment should remain quiet and clean. Once the condition stabilizes, a gradual transition to a light diet should begin, starting with liquid foods and progressing to semi-liquid foods. Avoid greasy and spicy foods to reduce gastrointestinal burden and support recovery.