Peritonitis is an inflammation of the peritoneum, which is the membrane that lines the wall of the abdomen and covers the abdominal organs.
Causes, Incidence & Risk factors
Types of peritonitis include:
- Spontaneous Peritonitis - an infection that occurs as a complication of ascites (a collection of fluid in the peritoneal cavity), which is usually related to liver or kidney failure
- Secondary Peritonitis - caused by another condition, most commonly the spread of an infection from the digestive organs or bowels
- Dialysis associated Peritonitis - This is an acute or chronic inflammation (irritation and swelling) of the peritoneum (lining of the abdominal cavity) that occurs in people receiving peritoneal dialysis
Intra-abdominal abscess (abdominal abscess).
This condition involves a collection of pus in the abdomen and may cause peritonitis. Before peritonitis develops, it can still cause symptoms that are similar or identical to peritonitis.
- An intra-abdominal abscess may arise due to the following:
- Localization of peritonitis
- Gastrointestinal perforation
- Anastomotic leak
- Haematogenous (bloodstream) spread
- Sites of gravitational drainage
- Subhepatic spaces
- Subphrenic spaces
- Paracolic gutters
- Abdominal pain, which increases on movement
- Abdominal tenderness & distension
- Low urine output
- Point tenderness
- Signs of shock in extreme cases
- Physical examination and medical history
- Blood tests including blood culture and X-rays or CT scans may be ordered
- Peritoneal fluid analysis (paracentesis) & culture
The cause must be identified and treated promptly.
Treatment typically involves fluid infusion to control shock, surgery to drain the peritoneal cavity and repair the cause, and antibiotics to deal with the infection. In cases associated with peritoneal dialysis, antibiotics may be infused through the dialysis catheter, but if the infection is severe, the catheter itself must often be removed.
Treatment typically involves surgery and antibiotics.
Course of Illness
The outcome is usually good with treatment, but can be poor without treatment. Sometimes the outcome is poor even with prompt and adequate treatment.
Peritonitis can be life-threatening and cause a number of different complications, depending on the type.
Complications may include
- Peritonitis stops the movement of bowel contents (peristalsis), which can block the bowel (paralytic ileus)
- Septic shock – Fluid from the blood accumulates in the abdominal cavity and the loss of fluid from the circulation may also cause shock
- Intraperitoneal adhesions