Definition

Peritonitis is an inflammation or infection of the peritoneum. The peritoneum is a thin tissue lining that covers the inside of the abdominal cavity. It also covers the outside of the intestines and other abdominal organs.

There are several types:

• Primary
• Secondary
• Peritoneal dialysis-related

Peritonitis is a serious condition. It requires immediate treatment. If not promptly treated, it can be fatal.

Causes

• Primary peritonitis—Occurs when there is a buildup of fluid in the abdomen. This is called ascites. It is caused by health conditions, such as cirrhosis (chronic liver disease).
• Secondary peritonitis—Caused by bacteria that enter the abdominal cavity. Can be due to an injury or a condition, such as a ruptured appendix.
• Dialysis-related peritonitis—Caused by bacteria that enter the peritoneal cavity during or after peritoneal dialysis (a treatment for kidney disease).

Risk Factors

Factors that may increase your chance of peritonitis include:

• Abdominal penetration or trauma
• Immune compromise
• Blood in the abdomen
• Ruptured appendix
• Peptic ulcer
• Colitis
• Diverticulitis
• Gangrene of the bowel
• Pancreatitis
• Pelvic inflammatory disease
• Inflamed gallbladder
• Recent surgery
• Tubes or shunts in the abdomen
• Cortisone drugs

Symptoms

Peritonitis may cause:

• Severe pain or tenderness in the abdomen
• Pain in the abdomen that is worse with motion
• Bloating of the abdomen
• Constipation
• Fever
• Nausea and vomiting
• Weakness or lightheadedness
• Shortness of breath
• Rapid pulse or breathing rate
• Dehydration —signs include dry skin and lips, decreased urine production

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

• Blood tests
• Analysis of fluids from the peritoneum
• Abdominal x-rays
• Laparotomy

Treatment

Treatment depends on the cause. It may include:

• Surgery to repair openings in the skin surface or to remove damaged tissue
• Antibiotics to treat infection
• Replacement of fluids

Prevention

There are no current guidelines to prevent peritonitis.

The American College of Gastroenterology http://patients.gi.org/

Health Canada http://www.hc-sc.gc.ca

Feldman M, et al. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. St. Louis: Mosby, 2005.

Olendorf D, Jeryan C, Boyden K. Gale Encyclopedia of Medicine. Detroit, MI: Gale Group Research Company; 2000.

Peritonitis. Mayo Clinic website. Available at:
http://www.mayoclinic.org/diseases-conditions/peritonitis/basics/definition/con-20032165
Updated July 2011. Accessed August 26, 2014.

Townsend CM, et al. Sabiston Textbook of Surgery. 17th ed. Philadelphia: Saunders, 2004.

Yamada T, Alpers DH, et al. Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003.