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Peritonitis

Definition

Peritonitis is an inflammation (irritation) of the peritoneum, the tissue that lines the wall of the abdomen and covers the abdominal organs.

Alternative Names

Acute abdomen

Causes

A collection of pus in the abdomen, called an intra-abdominal abscess, may cause peritonitis.

See the specific types of peritonitis:

• Peritonitis - spontaneous
• Peritonitis - secondary
• Peritonitis - dialysis associated

Symptoms

• Abdominal distention
• Abdominal pain or tenderness
• Fever
• Fluid in the abdomen
• Inability to pass feces or gas
• Low urine output
• Nausea and vomiting
• Point tenderness
• Thirst

Additional symptoms that may be associated with this disease include:

• Cloudy dialysis fluid (if undergoing peritoneal dialysis)
• Nausea and vomiting
• Shaking chills
• Signs of shock

Exams and Tests

The doctor will perform a physical exam. The abdomen is usually tender, and may feel firm and "board-like." The patient may extensively "guard" the area, using protective movements such as curling up or refusing to allow the area to be touched.

Blood tests, x-rays, and CT scans may be ordered.

Treatment

The cause must be identified and treated promptly. Treatment typically involves surgery and antibiotics.

Outlook (Prognosis)

With treatment, patients usually do well. Without treatment, the outcome is usually poor. However, in some cases, patients do poorly even with prompt and appropriate treatment.

Possible Complications

Peritonitis can be life threatening and may cause a number of different complications. Complications depend on the specific type of peritonitis.

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of peritonitis.

Prevention

Prevention depends on the cause. See the specific types of peritonitis.

References

Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum, and Retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2008:chap 43.

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