Bile peritonitis is a serious inflammatory disease of the peritoneum, caused by the entry of bile into the abdominal cavity. Clinical manifestations develop rapidly: Acute pain occurs in the left hypochondrium, vomiting, bloating, hypotension and tachycardia, and symptoms of intoxication increase. The general condition of the patient worsens right up to the violation of consciousness. Diagnosis consists in conducting a surgical examination, laboratory tests, ultrasound, an overview radiography and MSCT of the abdominal cavity. In an emergency procedure, surgical intervention is performed with elimination of the source of peritonitis, antibiotics, analgesics and antishock drugs, parenteral solutions are prescribed.
Causes of biliary peritonitis
Among the predisposing factors that increase the risk of development of destructive pathology of the gallbladder and bile ducts, there are: A prolonged course of diabetes mellitus, arteriosclerosis of the vessels, anemia, elderly and senile age, systemic and autoimmune diseases, frequent exacerbations of chronic pancreatitis.
Very rarely the disease develops without a specific cause as a result of increased pressure and microradia in the bile ducts against a background of severe inflammation of the pancreas, spasm of the sphincter of Oddi, embolism of the vessels, blood supply of the gallbladder and holedoch.
Symptoms of bile peritonitis
The clinical picture of the disease depends on the penetration rate and the amount of bile entered into the abdominal cavity, the area of the lesion. Slow flow of biliary contents leads to the development of chronic and subacute peritonitis with mild symptoms. The rapid penetration of bile into the peritoneal space leads to a pronounced symptomatology with a sharp deterioration in the patient’s condition. During the disease, several stages are isolated.
Treatment of bile peritonitis
The tactics of treatment depend on the initial disease, the extent of the lesion, and the general condition of the patient. At all stages of the disease, emergency surgical intervention is carried out, aimed at getting rid of the pathology that led to the development of peritonitis (perforation of the gallbladder, inconsistency of surgical sutures, etc.). When lesions of the bile ducts are performed cholecystectomy or choledochhotomy, drainage of the biliary tract, the imposition of repeated anastomosis, mandatory drainage and revision of the abdominal cavity. When idiopathic form of the disease is limited to sanation and drainage of the abdominal cavity. Along with the operation, the patient is shown carrying out detoxification, combined antibacterial, anti-inflammatory and analgesic therapy. Patients should be in the intensive care unit.