Enumerate the principles of management of peritonitis.
Management of peritonitis is an emergency and follows a structured approach. Resuscitation and stabilization are the first steps, including aggressive intravenous fluid therapy to correct hypovolemia, electrolyte correction, oxygen supplementation, analgesia, and close hemodynamic monitoring (vital signs, urine output). Broad-spectrum antibiotics should be initiated immediately to cover gram-negative and anaerobic gut flora, later tailored to culture results. Source control is definitive, involving surgical intervention to repair perforations, resect necrotic tissue, drain abscesses, and perform thorough peritoneal lavage. Supportive care is essential, including nutritional support (enteral or parenteral), gastric decompression via nasogastric tube, prophylaxis against deep vein thrombosis and stress ulcers, and intensive monitoring in an ICU for severe sepsis or shock. Early recognition, prompt antibiotic therapy, and timely surgical intervention are key to reducing morbidity and mortality associated with peritonitis.
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