Severe Abdominal Pain Case Study
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Added on 2021-04-24
Severe Abdominal Pain Case Study
Added on 2021-04-24
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Running head: SEVERE ABDOMINAL PAIN CASE STUDYSevere Abdominal Pain Case StudyName of StudentName of UniversityAuthor Note
1SEVERE ABDOMINAL PAIN CASE STUDYThe rapid treatment by medical staff, helped the progression of peritonitis into full blownsepsis( a form of systemic inflammatory response syndrome-SIRS). With reference topathophysiology, discuss the mechanisms of sepsis and SIRS and how it can disrupt thenormal functioning of the cardiovascular (e.g., significant reduction in blood pressuredespite increased heart rate), respiratory and renal systems. In your answer discuss thereasons why the described treatment was administered in relation to attempting to halt thedevelopment of SIRS.In the given case study, a subsequent peritonitis was the reason of acute abdominal painand on-time intravenous broad-spectrum antibiotics administration helped to prevent thedevelopment of sepsis (Mishra et al. 2014). Peritonitis is the inflammation of the inner wall ofabdomen called peritoneum that supports and protects the abdominal organs caused by bacteriaor fungal infection. Peritonitis is a serious condition that requires prompt antibioticsadministration for treating the infection. The symptoms depend on the underlying cause of theinfection. Fever, chills, nausea, abdominal rigidity and pain are the common symptoms that weremanifested in the 42-year-old male. Peritonitis from the extraperitoneal source inflammationoccurs from hematogens dissemination (Wu et al. 2013). It is caused by a single microorganismEscherichia coli, accounting for 70% of the infection that includes fluid resuscitation andantibiotics administration. Innate immune system is the non specific immunity that occurs since birth and protectsthe body from pathogens and recruits macrophages, mast cells and leucocytes that kill thepathogen non-specifically. These cells cause inflammation in the affected area and releasecytokines that in turn start the humoral immunity and complement system to kill the antigen
2SEVERE ABDOMINAL PAIN CASE STUDY(Mishra 2014). The innate immune system’s respond to peritonitis condition is orchestration andbeneficial for the expression of inflammatory cytokines (Mossie 2013). Cytokines are themembrane-bound small proteins of ±8 - 80 kDa that plays a central role in the negative andpositive immune responses and integration of these reactions to physiological systems such ashematopoietic and complement systems (Hecker et al. 2014). They act by binding to the specificreceptors on the cell membrane on target cells triggering a cascade of reactions like induction,inhibition or enhancement of cytokine-regulated genes in the target cell nucleus that modulatesimmunological activity of the cell. During peritonitis, mesothelial cells, reticuloendothelial cells,TNF-α and PMφ. IL-1β secrete cytokines where they are the primary mediators and leadingplayers of the inflammatory response (Mishra et al. 2014). There is uncontrolled activation ofsystemic inflammatory cascade by these cytokines that has worse outcomes for the patient.Therefore, peritonitis triggers a peritoneal and acute systemic innate immune response wherethere is release of pro and anti-inflammatory responses. Cytokines play a crucial role in the mediation of immune response of body anddevelopment of systemic inflammatory response syndrome (SIRS). SIRS is the condition whenperitonitis is left untreated that leads to severe complications like fever, chills, tachycardia andhigh respiratory rate (Wada et al. 2013). When it is untreated, it extend beyond the peritoneumthat may cause bloodstream infection and sepsis which is a life-threatening and rapidlyprogressing condition that can lead to organ failure and shock (Khanna et al. 2013). Theintraperitoneal or abscess cytokine response has serious implications for the host. Researchsuggests that bacterial peritonitis is associated with compartmentalized immense intraperitonealcytokine response. SIRS is an intensive and nonspecific reaction that is elicited by bacterialinfection in peritonitis. There is complex homeostatic disturbance as there is potential destructive
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