Peritonitis

Peritonitis

Peritonitis is inflammation of the tissue that lines the abdomen and covers the internal organs (peritoneum). Certain conditions or injuries can cause organs to leak stool, bacteria, fungi, blood, or chemicals, such as bile or other digestive fluids, into the abdomen. When these substances come into contact with the peritoneum, they may cause irritation or infection.

Peritonitis can be a life-threatening infection if not treated promptly. The infection can spread through the bloodstream and affect the whole body (sepsis).

What are the causes?

This condition may be caused by:

  • Infection of:
    • The appendix (appendicitis).
    • The pancreas (pancreatitis).
    • Diverticula (diverticulitis). These are small pouches that form in the lining of the digestive tract.
    • The lungs (tuberculosis).
  • Ulcers.
  • Crohn’s disease or ulcerative colitis.
  • Cancer.
  • Liver disease.

Other possible causes are:

  • Injury, such as injury to:
    • The abdomen.
    • The stomach.
    • The esophagus.
  • Other infections inside the abdomen or pelvis.
  • Pregnancy outside the uterus (tubal pregnancy).
  • A procedure that is used to cleanse the blood when the kidneys have stopped working correctly (peritoneal dialysis).

What are the signs or symptoms?

Symptoms of this condition include:

  • Severe pain in the abdomen.
  • Hard-feeling abdomen.
  • Swelling in the abdomen.
  • Fever and chills.
  • Nausea and vomiting.
  • Poor appetite or no appetite.
  • Being unable to pass gas or stool (constipation).
  • Diarrhea.
  • Passing urine less often.

How is this diagnosed?

This condition may be diagnosed based on the results of a physical exam and medical history. Your health care provider may also do:

  • A test on fluid removed from the infected area (paracentesis).
  • Lab tests such as blood, urine, or stool tests.
  • Imaging tests, such as X-ray, ultrasound, CT scan.

How is this treated?

Treatment for this condition includes treating the symptoms and treating the underlying cause. Usually this condition is treated in the hospital. Treatment may include:

  • Antibiotic medicines.
  • Surgery to remove infected fluid and tissue.
  • Surgery to treat the condition that caused peritonitis, such as removing the appendix to treat appendicitis (appendectomy).

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
  • If you were taking prescription medicines for other problems before you developed peritonitis, ask your health care provider when you should start taking these medicines again.
  • If told by your health care provider, use a stool softener or laxative.

General instructions

  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Do not drink alcohol.
  • Follow your health care provider’s instructions for diet and activity.
  • Drink enough fluid to keep your urine pale yellow.
  • Rest as much as possible.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You develop a fever or chills.
  • You are constipated.
  • You have nausea, vomiting, or diarrhea.
  • Your symptoms change or get worse.

Get help right away if you:

  • Have new or worse pain in your abdomen.
  • Have new problems with passing urine.
  • Develop chest pains or shortness of breath.
  • Become very confused or drowsy.
  • Have jerky movements that you cannot control (seizures).

Summary

  • Peritonitis is inflammation of the tissue that lines the abdomen and covers the internal organs (peritoneum).
  • Symptoms include pain and swelling in the abdomen, fever and chills, nausea and vomiting, poor appetite, constipation, diarrhea, or passing urine less often.
  • Treatment includes treating the symptoms that you have and treating the underlying cause with medicine or surgery.
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