localised peritonitis
Investigations are those listed on “investigations for acute
abdomen” slide
All patients get simple investigations
Complex investigations are requested depending on suspected diagnosis (remember that some diagnoses do not require complex investigations and are entirely based on history and examination e.g. Appendicitis)
If generalised peritonitis
Surgical emergency – will require emergency operation
Following investigations should be performed:
Bloods: FBC, U&E, LFT, Amylase!! (acute pancreatitis can present with generalised peritonitis and does not require emergency surgery), CRP, clotting, G&S, ABG
AXR and Erect CXR
CT scan
Only if this can be performed urgently and patient is stable
If this can not be performed urgently or patient is unstable then for surgery without delay
Does not change management (i.e. Patients will need emergency surgery regardless) but useful as will identify cause of peritonitis therefore helping to plan surgical procedure
Other Time consuming complex investigations should not be performed as they will only delay definitive treatment (emergency surgery) and add very little
Investigations for Peritonitis