The peritoneum is the lining of the inner abdominal wall. It serves as a protective covering for the abdominal organs. Peritonitis is a infection of the peritoneum, usually from bacteria.

Causes of Peritonitis

There are many causes of peritonitis. These may include:

  • Gastointestinal disorders such as diverticulitis or Crohn's disease.
  • A rupture of a stomach ulcer, the appendix, or a large intestine diverticulum
  • Perforations of an abdominal organ
  • Pancreatitis
  • Pelvic inflammatory disease or infection 


Symptoms of Peritonitis

Since peritonitis may be a life-threatening condition, patients should be alert to its symptoms, especially after abdominal disease or injury, abdominal surgery, or when undergoing peritoneal dialysis. Symptoms of peritonitis may include:

  • Fever
  • Chills
  • Abdominal pain or bloating
  • Loss of appetite
  • Nausea
  • Thirst
  • Fatigue
  • Inability to pass stool or gas
  • Urinary retention

Dialysis patients should contact their health care providers if their peritoneal dialysis fluid shows any of the following signs of contamination:

  • Cloudiness
  • Contains white flecks
  • Contains clumps or strands
  • Odor

Diagnosis of Peritonitis

To diagnose peritonitis, a doctor will perform a review of systems and physical examination. Additional testing may include:

  • Blood tests
  • Imaging tests, such as X-rays or CT scans
  • Laboratory culture of peritoneal fluid
  • Exploratory surgery

Risks of Peritonitis

The most dangerous risk of peritonitis is sepsis and septic shock which require immediate intensive care. Sepsis occurs when the body mobilizes to attack systemic infection by releasing chemicals into the bloodstream. These chemicals can trigger inflammation throughout the body which may cause organ failure. If septic shock occurs, the patient's blood pressure may drop precipitously and may be life threatening.

Treatment of Peritonitis

Peritonitis is a very serious condition and may require hospitalization. Patients with peritonitis are typically treated with antibiotics, either intravenously or into the abominal cavity through the peritoneal dialysis catheter.  In severe cases, surgery may be required. 

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