Gastrointestinal system peritonitis

In severe cases, or those refractory to treatment, truncal and limb weakness may be accompanied by involvement of masticatory, bulbar, and respiratory muscles. However the most life-threatening clinical manifestations are those affecting the gastrointestinal tract, since stomach ulceration can occur and death from perforation and peritonitis are not unknown. Medication with steroidal antiinflammatory agents is necessary but weakens the childrens resistance to infection, so that systemic spread of usually self-limiting disorders, such as candidiasis, may occasionally occur. 

Nausea and vomiting may be manifestations of a wide variety of conditions, including adverse effects from medications systemic disorders or infections pregnancy vestibular dysfunction central nervous system infection or increased pressure peritonitis hepatobiliary disorders radiation or chemotherapy and gastrointestinal obstruction, dysmotility, or infections. 

SAFETY PROFILE Poison by intravenous route. Moderately toxic by ingestion and intraperitoneal routes. Human systemic effects by intravenous route peritonitis, central nervous system, and gastrointestinal changes. An experimental teratogen. Other experimental reproductive effects. When heated to decomposition it emits toxic fumes of F", POx, and Na20. 

Smooth Muscle Local anesthetics depress contractions in gastrointestinal (Gl), vascular, and bronchial smooth muscle, although low concentrations initially may produce contraction. Spinal and epidural anesthesia, as well as instillation of local anesthetics into the peritoneal cavity, cause sympathetic nervous system paralysis, which can result in increased tone of Gl musculature see below). Local anesthetics seldom depress uterine contractions directly during intrapartum regional anesthesia. 

Most HE episodes in patients with chronic liver disease are precipitated by events such as oral protein load, gastrointestinal bleeding, obstipation, infection, especially peritonitis, hypokalemia and alkalosis complicating the use of diuretic drugs, administration of sedative drugs, for example for diagnostic procedures or induction of portal-systemic shunt via shunt operation or the TIPSS implantation. 

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