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Journal de Chirurgie 2005Sclerosing peritonitis (also described as sclerosing obstructive peritonitis, encapsulating peritonitis, obliterative adhesive peritonitis, abdominal cocoon syndrome) is... (Review)
Review
Sclerosing peritonitis (also described as sclerosing obstructive peritonitis, encapsulating peritonitis, obliterative adhesive peritonitis, abdominal cocoon syndrome) is not well-known by the general surgeon; most reviews of this subject occur in the nephrology literature. Peritoneal dialysis and continuous hyperthermic peritoneal perfusion are the main causes. No controlled study exists to evaluate the optimal therapeutic approach. Pre-operative diagnosis is difficult since the clinical signs and radiologic findings are non-specific. Nevertheless, the diagnosis should be considered when small bowel obstruction with proximal dilatation, ascites, and thickened or calcified peritoneum are seen on imaging. The surgeon should recognize sclerosing peritonitis grossly when it is encountered and adapt his surgical strategy accordingly.
Topics: Humans; Peritoneum; Peritonitis; Sclerosis
PubMed: 15976629
DOI: 10.1016/s0021-7697(05)80854-3 -
International Journal of Molecular... May 2023In peritoneal dialysis (PD) patients, fungi and are considered important causative microorganisms for peritonitis with poor prognosis. Our objective was to explore...
In peritoneal dialysis (PD) patients, fungi and are considered important causative microorganisms for peritonitis with poor prognosis. Our objective was to explore expressions of membrane complement (C) regulators (CRegs) and tissue injuries in the peritoneum of patients with PD-related peritonitis, including fungal and peritonitis. In peritoneal biopsy tissues obtained at PD catheter removal, we investigated the severity of peritonitis-associated peritoneal injuries and the expression of CRegs, CD46, CD55, and CD59 against peritoneal tissues without any episode of peritonitis. In addition, we evaluated peritoneal injuries among fungal and -peritonitis (P1) and Gram-positive bacterial peritonitis (P2). We also observed deposition of C activation products such as activated C and C5b-9 and measured sC5b-9 in the PD fluid of patients. As a result, the severity of peritoneal injuries correlated inversely with the expression of peritoneal CRegs. Peritoneal CReg expression in peritonitis was significantly reduced compared to no peritonitis. Peritoneal injuries were more severe in P1 than in P2. CReg expression was further decreased and C5b-9 further increased in P1 than in P2. In conclusion, severe peritoneal injuries due to fungal and -peritonitis decreased CReg expression and increased deposition of activated C3 and C5b-9 in the peritoneum, suggesting that peritonitis, particularly fungal and -peritonitis, might induce susceptibility to further peritoneal injuries due to excessive C activation.
Topics: Humans; Peritoneum; Complement Membrane Attack Complex; Complement Activation; Peritoneal Dialysis; Peritonitis; Immunologic Factors
PubMed: 37298097
DOI: 10.3390/ijms24119146 -
Pediatric Nephrology (Berlin, Germany) Jan 2008In long-term peritoneal dialysis (PD) morphological and functional changes of the peritoneal membrane are common. Sub-mesothelial fibrosis, angiogenesis and vasculopathy... (Review)
Review
In long-term peritoneal dialysis (PD) morphological and functional changes of the peritoneal membrane are common. Sub-mesothelial fibrosis, angiogenesis and vasculopathy are typical histomorphological alterations of the peritoneal membrane, which, to a certain degree, are induced by uremia and recurrent peritonitis. The most important causative factor, however, represents the chronic exposure to PD solutions. Glucose, glucose degradation products and advanced glycation end-products (AGEs) via different pathways induce inflammation, fibrosis and angiogenesis. As a functional consequence ultrafiltration failure due to peritoneal hyperpermeability and an increased effective peritoneal surface area represents a major clinical problem. An insufficient function of the water-selective aquaporin 1 (AQP-1) channel may also be causative for inadequate ultrafiltration. A rare but life-threatening complication of long-term PD is encapsulating peritoneal sclerosis (EPS). For both impaired AQP-1 function and EPS, the long-term effects of PD fluids are believed to be responsible, even though the mechanisms are not yet understood. The avoidance of glucose and modern PD fluids with fewer glucose degradation products, as well as first pharmacological attempts may help to preserve the peritoneal membrane in the long term.
Topics: Aquaporin 1; Humans; Peritoneal Dialysis; Peritoneum; Peritonitis; Sclerosis
PubMed: 17638023
DOI: 10.1007/s00467-007-0541-z -
Nephron 1999
Review
Topics: Humans; Macrophages, Peritoneal; Peritoneal Dialysis, Continuous Ambulatory; Peritoneum; Peritonitis
PubMed: 10357643
DOI: 10.1159/000045318 -
Kidney International Mar 1981Peritonitis during peritoneal dialysis is the most frequent complication associated with this dialysis technique. We studied patients undergoing peritoneal dialysis when...
Peritonitis during peritoneal dialysis is the most frequent complication associated with this dialysis technique. We studied patients undergoing peritoneal dialysis when they were without peritonitis and during episodes of clinical infection. Peritonitis was associated with a significantly decreased dialysate effluent volume, increased absorption of glucose, clearance of urea and creatinine, and protein loss in the dialysate effluent. We suggest that the changes occurring to the peritoneal dialyzing surface with peritonitis might be explained by alterations in peritoneal blood flow, effective membrane surface area, or permeability.
Topics: Adult; Aged; Female; Glucose; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritoneum; Peritonitis; Proteins; Regional Blood Flow
PubMed: 7241884
DOI: 10.1038/ki.1981.40 -
Peritoneal Dialysis International :... 1995
Topics: Cytokines; Epithelium; Humans; Infections; Peritoneal Dialysis, Continuous Ambulatory; Peritoneum; Peritonitis
PubMed: 7612730
DOI: No ID Found -
Journal of Equine Veterinary Science Jan 2021Intraperitoneal ceftriaxone administration in healthy horses results in high and prolonged peritoneal concentrations. Recent findings suggest that intraperitoneal...
Intraperitoneal ceftriaxone administration in healthy horses results in high and prolonged peritoneal concentrations. Recent findings suggest that intraperitoneal ceftriaxone might increase survival rates in horses affected by peritonitis. The present study aimed to evaluate plasma and peritoneal concentrations of ceftriaxone after intraperitoneal administration in horses with septic peritonitis. Twenty-six horses presenting clinical, laboratorial, and sonographic findings compatible with the disease were included. All horses received daily intraperitoneal ceftriaxone (25 mg/kg bwt) in addition or not with other antibiotics and support therapies. High-performance liquid chromatography was used to determine plasma and peritoneal ceftriaxone concentrations before and after 12 and 24 hours of ceftriaxone administration. Mean plasma concentrations 12 and 24 hours after administration were, respectively, 1.84 ± 0.43 and 0.37 ± 0.07 μg/mL, and mean peritoneal concentrations were 5.7 ± 2.84 and 0.42 ± 0.13 μg/mL. Ceftriaxone concentration was lower in comparison with previous studies in healthy horses and presented under the minimal inhibitory concentration for enterobacteria (≤1 μg/mL) and for gram-positive isolates (≤0.5 μg/mL) at 24 hours. The variation of the results obtained between healthy horses and with septic peritonitis demonstrated that pharmacokinetics/dynamics are different between these patients and suggests the use of an interval of dose of 12 hours.
Topics: Animals; Ceftriaxone; Horse Diseases; Horses; Injections, Intraperitoneal; Peritoneum; Peritonitis; Plasma
PubMed: 33349404
DOI: 10.1016/j.jevs.2020.103310 -
Hepato-gastroenterology 1997The peritoneal cavity can be divided in the supracolic infracolic and paracolic spaces, the lesser sack and the pelvis. The peritoneum is a semipermeable membrane which... (Review)
Review
The peritoneal cavity can be divided in the supracolic infracolic and paracolic spaces, the lesser sack and the pelvis. The peritoneum is a semipermeable membrane which allows a flux of solutes into and from the peritoneal cavity. In addition, particles can be absorbed through the stomata of the diaphragmatic peritoneum. Secondary peritonitis is always a polymicrobial infection. The flora consists of aerobic enterobacteriaeceae and anaerobs mainly B. fragilis. These two groups of bacteria act synergistically. Besides unspecific defence mechanisms, i.e. the direct absorption of bacteria and the entrapment of bacteria in fibrin, the immunological defence mechanisms of the peritoneal cavity are triggered by endotoxin contained in the cell wall of the invading bacteria leading to the production of cytokines by macrophages, activation of complement and as a result the migration of granulocytes from the intervascular space into the peritoneal cavity.
Topics: Animals; Ascitic Fluid; Bacteria; Bacterial Adhesion; Bacterial Infections; Cytokines; Granulocytes; Humans; Lipopolysaccharides; Macrophages, Peritoneal; Peritoneum; Peritonitis; Virulence
PubMed: 9261580
DOI: No ID Found -
The Surgical Clinics of North America Apr 1988Peritonitis continues to be one of the major infectious problems confronting surgeons. Despite the many advances in antimicrobial agents and supportive care, mortality... (Review)
Review
Peritonitis continues to be one of the major infectious problems confronting surgeons. Despite the many advances in antimicrobial agents and supportive care, mortality from diffuse suppurative peritonitis remains unacceptably high. The authors review the anatomy and defense capabilities of the peritoneal cavity and then focus on the polymicrobial nature of peritonitis and how, through microbial interactions with host defenses, there is either resolution or persistent infection. They also consider possible infection-potentiating agents in the peritoneal cavity and experimental modes of therapy.
Topics: Abdomen, Acute; Animals; Anti-Infective Agents; Anticoagulants; Humans; Immunotherapy; Peritoneal Cavity; Peritonitis
PubMed: 3279556
DOI: 10.1016/s0039-6109(16)44487-7 -
Journal of the American Society of... Jul 2007Peritoneal dialysis (PD) is a form of renal replacement and is based on the use of the peritoneum as a semipermeable membrane across which ultrafiltration and diffusion... (Review)
Review
Peritoneal dialysis (PD) is a form of renal replacement and is based on the use of the peritoneum as a semipermeable membrane across which ultrafiltration and diffusion take place. Nevertheless, continuous exposure to bioincompatible PD solutions and episodes of peritonitis or hemoperitoneum cause acute and chronic inflammation and injury to the peritoneal membrane, which progressively undergoes fibrosis and angiogenesis and, ultimately, ultrafiltration failure. The pathophysiologic mechanisms that are involved in peritoneal functional impairment have remained elusive. Resident fibroblasts and infiltrating inflammatory cells have been considered the main entities that are responsible for structural and functional alterations of the peritoneum. Recent findings, however, demonstrated that new fibroblastic cells may arise from local conversion of mesothelial cells (MC) by epithelial-to-mesenchymal transition (EMT) during the inflammatory and repair responses that are induced by PD and pointed to MC as protagonists of peritoneal membrane deterioration. Submesothelial myofibroblasts, which participate in inflammatory responses, extracellular matrix accumulation, and angiogenesis, can originate from activated resident fibroblasts and from MC through EMT. This heterogeneous origin of myofibroblasts reveals new pathogenic mechanisms and offers novel therapeutic possibilities. This article provides a comprehensive review of recent advances on understanding the mechanisms that are implicated in peritoneal structural alterations, which have allowed the identification of the EMT of MC as a potential therapeutic target of membrane failure.
Topics: Epithelial Cells; Fibrosis; Humans; Mesoderm; Peritoneal Dialysis; Peritoneum; Peritonitis
PubMed: 17568021
DOI: 10.1681/ASN.2006111292