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 chronic liver disease, among other conditions.
• Secondary peritonitis—caused by bacteria that enter the abdominal cavity. 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).

Secondary Peritonitis

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Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for peritonitis include:

• 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

Symptoms may include:

• 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 dizziness
• 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, and perform a physical exam. Tests may include:

• Blood tests
• Analysis of fluids from the peritoneum
• Abdominal x-rays—to look for signs of inflammation
• Laparotomy—surgery to open and examine the abdomen

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

If you are diagnosed with peritonitis, follow your doctor's instructions.

Prevention

There are no guidelines for preventing peritonitis.

Resources

Canadian Resources