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Why do bowel peforation and strangulation have similar signs

  1. Oct 5, 2015 #1
    Hello everyone,

    From what I have read I have deduced that both bowel peforation and strangulation have same clinical features, which are fever, leukocytosis, pain, tenderness, increase in vital signs (eg tachycardia)

    1. Why is this? Is it becase strangulation bowel (which means necrosis really) eventually lead to peforation. If not how do you differentiate between the two?

    2. If bowel peforation occurs, peritonitis is bound to happen, so are these clinical features due to peritonitis. If not why do these two things cause these clinical features. Eg why cause fever?

    3. If some abdominal organ burst, peritonitis can occur. If a thoracic organ occurs infection of thoracic cabity can occur, what do you call that?

    Thanks a lot :smile:
  2. jcsd
  3. Oct 5, 2015 #2

    jim mcnamara

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    Staff: Mentor

    1 and 2 are the result of bacteria from inside of the colon escaping into surrounding tissue.

    As for #3 could you please reword it? I do not get what you are asking. The pericardium of the heart constrains bacteria from already existing heart infections from spreading outward. Is that what you mean? The pleural sac around the lungs kind of works the same way.
  4. Oct 5, 2015 #3
    Thanks for the reply. What I mean from 3rd question is, inflammation of peritoneal cavity is called peritonitis, so like wise what is the scientific term for inflammation of thoracic cavity? So either pleuritis or pericarditis I suppose. Any way so the reason that both strangulation and peforation have same clinical features is as you have said both lead to similar outcome, bacterial leak out. Is that right ?
  5. Oct 5, 2015 #4
    Inflammation within the mediastinum is called mediastinitis. Infection with in the pleura is called empyema. Infection with in the pericardium can be suppurative pericarditis.

    The difference between strangulation and perforation is mildly academic. Strangulation causes Ischaemia of tissues and therefore massive cytokine release. This explains the systemic inflammatory response and the sympathetic nervous system stimulation. The treatment is much the same ie operative management although with perforation there is a greater need for more thorough washout in order to prevent abscess formation over the following days
  6. Oct 5, 2015 #5

    jim mcnamara

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    Staff: Mentor

    Thanks - I did not fully understand the questions. @hugh reid You did...

    "Cytokine release syndrome" when severe == "cytokine storm" two possible google searches for the OP.
  7. Oct 6, 2015 #6
    Thanks for all the help

    @Hugh: Yeah that is what I meant from 3rd question. It seems mediastinitis is the word I was after. However inflammation of pleura is pleuritis, and empyema is collection of pus in pleura. I think that is what you meant when you said infection in pleura instead of inflammation. Yeah cytokin release explains the clinical features well

    @Jim: Yeap good topics to search for me.
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