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 (chronic liver disease).
  • 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

Factors that may increase your chance of peritonitis include:

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

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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

Gastro—American Gastroenterological Association
http://gastro.org

The American College of Gastroenterology
http://gi.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
http://www.cag-acg.org

Health Canada
http://www.hc-sc.gc.ca

References

Bacterial peritonitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 1, 2014. Accessed August 26, 2014.

Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. St. Louis: Mosby, 2005.

Olendorf D, Jeryan C, Boyden K. Gale Encyclopedia of Medicine. Detroit, MI: Gale Group Research Company; 2000.

Peritonitis. Mayo Clinic website. Available at: http://www.mayoclinic.org/diseases-conditions/peritonitis/basics/definition/con-20032165. Updated July 2011. Accessed August 26, 2014.

Townsend CM, et al. Sabiston Textbook of Surgery. 17th ed. Philadelphia: Saunders, 2004.

Yamada T, Alpers DH, et al. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003.

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