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Peritonitis: pathophysiology and local defense mechanisms

R Heemken1, L Gandawidjaja, T Hau

  • 1Klinik für Allgemein, Thorax und Gefässchirurgie, Nordwest-Krankenhaus Sanderbusch Sande, Germany.

Hepato-Gastroenterology
|July 1, 1997
PubMed
Summary

Secondary peritonitis involves polymicrobial infections, primarily aerobic enterobacteriaceae and anaerobes like B. fragilis. The peritoneal cavity mounts an immune response involving cytokine production and granulocyte migration.

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Area of Science:

  • Immunology
  • Microbiology
  • Anatomy

Background:

  • The peritoneal cavity, a crucial anatomical space, facilitates solute exchange and particle absorption.
  • Secondary peritonitis is characterized by polymicrobial infections, often involving aerobic enterobacteriaceae and anaerobic bacteria such as B. fragilis.
  • These bacterial groups exhibit synergistic interactions within the peritoneal environment.

Purpose of the Study:

  • To elucidate the defense mechanisms of the peritoneal cavity against polymicrobial infections.
  • To describe the immunological response triggered by bacterial endotoxins.

Main Methods:

  • The study reviews the anatomical divisions of the peritoneal cavity and the peritoneal membrane's properties.
  • It discusses the composition of microbial flora in secondary peritonitis.

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  • It outlines the innate and immunological defense mechanisms activated.

    • Main Results:

    • The peritoneum acts as a semipermeable membrane, allowing solute flux and particle absorption.
    • Unspecific defenses include bacterial absorption and fibrin entrapment.
    • Immunological defenses are initiated by bacterial endotoxins, leading to cytokine production, complement activation, and granulocyte recruitment.

    Conclusions:

    • The peritoneal cavity employs a multi-faceted defense strategy against polymicrobial infections.
    • Both innate and adaptive immune responses are critical in managing peritoneal infections.
    • Understanding these mechanisms is vital for treating secondary peritonitis.