Definition

Peritonitis is an inflammation of the peritoneum (the thin tissue that lines the inner abdominal wall and covers most of the abdominal organs). It is usually caused by a bacterial or fungal infection. Peritonitis can result from any rupture in the abdomen or a complication of another medical condition. The most common symptom is intense abdominal pain in which case, immediate medical attention is vital.

Left untreated, it can rapidly spread into the blood and to other organs, causing multiple organ failure and death. Treatment options for peritonitis usually involve antibiotics and in more severe cases, surgery.

 

Symptoms

Signs and symptoms of peritonitis may include the following:

·         Abdominal pain or tenderness

·         Bloating

·         High temperature

·         Nausea and vomiting

·         Extreme thirst

·         Tiredness

·         Loss of appetite

·         Diarrhea

·         Inability to urinate or have a bowel movement

 

If an individual is receiving peritoneal dialysis, peritonitis symptoms may also include:

·         Cloudy dialysis fluid

·         White spots or clumps in the dialysis fluid

 

Causes

The two main types of peritonitis are:

•  Primary spontaneous peritonitis: An infection that develops in the peritoneum without an abdominal rupture (usually due to a complication of liver disease such as cirrhosis)
•  Secondary peritonitis: An injury or infection in the abdominal cavity that allows infectious organisms into the peritoneum.

In most cases, the cause is a rupture within the abdominal wall.  The ruptures can cause spillage of bacteria or chemicals from different parts of the body to enter into the peritoneum and cause contamination.  Common causes of ruptures that lead to peritonitis include:

·         Medical procedures, such as peritoneal dialysis

·         A ruptured appendix, stomach ulcer or perforated colon

·         Pancreatitis: Inflammation of the pancreas

·         Diverticulitis: Infection of small, bulging pockets in the digestive tract

·         Injury or trauma

 

Risk factors

Several factors that can increase the risk of developing peritonitis include:

·         Peritoneal dialysis. Peritonitis is common among individuals undergoing peritoneal dialysis therapy (unsanitary surroundings/germs surrounding the catheter)

·         Certain medical conditions (Cirrhosis, appendicitis, Crohn's disease, stomach ulcers, diverticulitis and pancreatitis)

·         Personal history of peritonitis

 

 

 

Complications

Left untreated, peritonitis can extend beyond the peritoneum and cause further complications in the body such as:

·         Bacteremia: An infection of the bloodstream

·         Sepsis: A life-threatening condition that involves the spreading of an infection throughout the entire body

 

Treatment

Treatment options for peritonitis depend on the exact cause of the condition. If it is caused by an infection from other medical conditions (secondary peritonitis), treatment options may include the following:

·         Antibiotics to help fight the infection and prevent it from spreading (the type and duration of antibiotic therapy depend on the severity of the condition and the type of peritonitis an individual is suffering from)

·         Surgery to remove the infected tissue and treat the underlying cause of the infection 

·         Other medical treatments (pain medications, intravenous (IV) fluids, supplemental oxygen, a blood transfusion)

 

Prevention

Often, peritonitis associated with peritoneal dialysis is caused by unsanitary surroundings and bacteria around the catheter that enters into the body. A few recommendations for preventing peritonitis include:

• Practicing good hygiene and washing hands at all times
• Cleaning the skin around the catheter with an antiseptic every day
• Storing medical supplies in a sanitary area
• Wearing a surgical mask during dialysis fluid exchanges
• Avoiding sleeping with pets to prevent further bacterial exchanges