CEN Peritonitis

CEN Peritonitis Overview

Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection. There are two types of peritonitis:

• Spontaneous bacterial peritonitis. Sometimes, peritonitis develops as a complication of liver disease, such as cirrhosis, or of kidney disease.
• Secondary peritonitis. Peritonitis can result from rupture (perforation) in your abdomen, or as a complication of other medical conditions.

Peritonitis requires prompt medical attention to fight the infection and, if necessary, to treat any underlying medical conditions. Peritonitis treatment usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body.

Signs and Symptoms

• Abdominal pain or tenderness
• Bloating or a feeling of fullness in your abdomen
• Fever
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Low urine output
• Thirst
• Inability to pass stool or gas
• Fatigue
• Confusion

Causes

• Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis may also develop as a complication of gastrointestinal surgery, the use of feeding tubes, or a procedure to withdraw fluid from your abdomen, and rarely as a complication of a colonoscopy or endoscopy.
• A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract.
• Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spreads outside the pancreas.
• Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulosis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity.
• Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum.

Risk Factors

• Peritoneal dialysis. Peritonitis can occur in people undergoing peritoneal dialysis therapy.
• Other medical conditions. The following medical conditions, among others, increase your risk of developing peritonitis: liver cirrhosis, appendicitis, Crohn’s disease, stomach ulcers, diverticulitis and pancreatitis.
• History of peritonitis. Once you’ve had peritonitis, your risk of developing it again may be higher than it is for someone who has never had peritonitis.

Complications

Left untreated, peritonitis can extend beyond your peritoneum, where it may cause:

• An infection throughout your body (sepsis). Sepsis is a rapidly progressing, life-threatening condition that can cause shock, organ failure and death.

Treatments

• Antibiotics. You’ll likely be given a course of antibiotic medication to fight the infection and prevent it from spreading. The type and duration of your antibiotic therapy will depend on the severity of your condition and the kind of peritonitis you have. You may be given an antibiotic that treats a wide spectrum of bacteria until doctors have more information about the specific bacteria causing your infection. Then they can more narrowly target your antibiotic.
• Surgery. Surgery is often needed to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading, especially if peritonitis is due to a ruptured appendix, stomach or colon.
• Other treatments. Depending on your signs and symptoms, your treatment while in the hospital will likely include pain medications, fluids given through a tube (intravenous fluids), oxygen and, in some cases, a blood transfusion.