Peritonitis
Definition
Peritonitis is an inflammation or infection of the peritoneum. The peritoneum is a thin tissue lining that covers the inside of the abdominal cavity. It also covers the outside of the intestines and other abdominal organs.
There are several types:
- Primary
- Secondary
- Peritoneal dialysis-related
Peritonitis is a serious condition. It requires immediate treatment. If not promptly treated, it can be fatal.
Causes
- Primary peritonitis—occurs when there is a buildup of fluid in the abdomen. This is called ascites. It is caused by health conditions, such as cirrhosis of the liver.
- Secondary peritonitis—caused by bacteria that enter the abdominal cavity. It can be due to an injury or a condition, such as a ruptured appendix.
- Dialysis-related peritonitis—caused by bacteria that enter the peritoneal cavity during or after peritoneal dialysis (a treatment for kidney disease).
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Risk Factors
Factors that may increase your chances of peritonitis:
- Abdominal penetration or trauma
- Immune compromise
- Blood in the abdomen
- Ruptured appendix
- Peptic ulcer
- Colitis
- Diverticulitis
- Gangrene of the bowel
- Pancreatitis
- Pelvic inflammatory disease
- Inflamed gallbladder
- Recent surgery
- Tubes or shunts in the abdomen
- Cortisone drugs
Symptoms
Peritonitis may cause:
- Severe pain or tenderness in the abdomen
- Pain in the abdomen that is worse with motion
- Bloating of the abdomen
- Constipation
- Fever
- Nausea and vomiting
- Weakness or lightheadedness
- Shortness of breath
- Rapid pulse or breathing rate
- Dehydration—signs include dry skin and lips, decreased urine production
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
- Blood tests
- Analysis of fluids from the peritoneum
- Abdominal x-rays
- Laparotomy
Treatment
Treatment depends on the cause. It may include:
- Surgery to repair openings in the skin surface or to remove damaged tissue
- Antibiotics to treat infection
- Replacement of fluids
Prevention
There are no current guidelines to prevent peritonitis.
RESOURCES:
American College of Gastroenterology
http://patients.gi.org
American Gastroenterological Association
http://www.gastro.org
CANADIAN RESOURCES:
Canadian Digestive Health Foundation
http://www.cdhf.ca
Health Canada
https://www.canada.ca
REFERENCES:
Bacterial peritonitis. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T115066/Bacterial-peritonitis. Updated May 31, 2017. Accessed October 3, 2017.
Spontaneous bacterial peritonitis (SBP). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/spontaneous-bacterial-peritonitis-sbp. Updated May 2016. Accessed October 3, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 9/4/2020