What Is Peritonitis?

You have a thin layer of tissue covering the inside of your

abdomen and most of its organs. This is called
the peritoneum. Peritonitis is inflammation of the peritoneum.
The inflammation is usually the result of a fungal or bacterial
infection caused by an abdominal injury, an underlying
medical condition, or a treatment device, such as a dialysis
catheter or feeding tube.
Peritonitis is a serious condition that needs immediate
medical attention. Prompt intravenousantibiotics are needed
to treat the infection. Surgery is sometimes necessary to
remove infected tissue. The infection can spread and become
life-threatening if it isnt treated promptly.
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What Causes Peritonitis?

There are two types of peritonitis. Spontaneous bacterial

peritonitis (SBP) is the result of an infection of the fluid in
your peritoneal cavity. Liver or kidney failure can cause this

condition. People on peritoneal dialysis for kidney failure are

also at increased risk for SBP.
Secondary peritonitis is usually due to an infection that has
spread from your digestive tract.
The following conditions can lead to peritonitis:

an abdominal wound or injury

a ruptured appendix
a stomach ulcer
a perforated colon
diverticulitis, which is when pouches form on the wall of
the colon and become inflamed
pancreatitis, which is an inflammation of the pancreas
cirrhosis of the liver or other types of liver disease
infection of the gallbladder, intestines, or bloodstream
pelvic inflammatory disease, which is an infection of a
womans reproductive organs
Crohns disease, which is a type of inflammatory bowel
disease
invasive medical procedures, including treatment for
kidney failure, surgery, or the use of a feeding tube

Symptoms of Peritonitis

Symptoms will vary depending on the underlying cause of

your infection. Common symptoms of peritonitis include:
tenderness in your abdomen
pain in your abdomen that gets more intense with
motion or touch
abdominal bloating or distention
nausea and vomiting
diarrhea
constipation or the inability to pass gas
minimal urine output
anorexia, or loss of appetite
excessive thirst
fatigue
fever and chills
If youre on peritoneal dialysis, your dialysis fluid may appear
cloudy or have white flecks or clumps in it. You may also
notice redness or feel pain around your catheter.

Diagnosing Peritonitis

If you have symptoms of peritonitis, seek medical attention

right away. Delaying your treatment could put your life at
risk.
Your doctor will ask you about your medical history and
perform a complete physical exam. This will include touching
or pressing on your abdomen, which will probably cause
some discomfort.
There are other tests to help diagnose peritonitis:
A blood test, called a complete blood count (CBC) can
measure your white blood cell count. A high white blood
cell count usually signals inflammation or infection. A
blood culture can help to identify the bacteria causing
the infection or inflammation.
If you have a buildup of fluid in your abdomen, your
doctor can use a needle to remove some and send it to a
laboratory for fluid analysis. Culturing the fluid can also
help identify bacteria.
Imaging tests, such as CT scans and X-rays, can show
any perforations or holes in your peritoneum.

If youre on dialysis, your doctor may diagnose you based on

the appearance of cloudy dialysis fluid.

How Peritonitis Is Treated

The first step in treating peritonitis is determining its

underlying cause. Treatment usually involves antibiotics to
fight infection and medication for pain.
If you have infected bowels, an abscess (a collection of pus),
or an inflamed appendix, you may need surgery to remove
the infected tissue.
If youre on kidney dialysis and have peritonitis, you may
have to wait until the infection clears up to receive more
dialysis. If the infection continues, you might need to switch
to a different type of dialysis.
Your treatment must begin promptly to avoid serious and
potentially fatal complications.

Complications from Peritonitis

If its not treated promptly, the infection may enter your

bloodstream, causing shock and damage to your other
organs. This can be fatal.
The potential complications of spontaneous peritonitis
include:
hepatic encephalopathy, which is a loss of brain function
that occurs when the liver can no longer remove toxic
substances from your blood
hepatorenal syndrome, which is progressive kidney
failure
sepsis, which is a severe reaction that occurs when the
bloodstream becomes overwhelmed by bacteria
The complications of secondary peritonitis include:
an intra-abdominal abscess, which is a collection of pus
gangrenous bowel, which is dead bowel tissue
intraperitoneal adhesions, which are bands of fibrous
tissue that join abdominal organs and can cause bowel
blockage
septic shock, which is characterized by dangerously low
blood pressure

How to Prevent Peritonitis

If youre on dialysis, wash your hands and fingernails before

touching your catheter. Clean the skin around the catheter
daily. Follow your doctors instructions regarding the care and
storage of your medical supplies.
See your doctor, go to an emergency room, or call 911 if you
have severe abdominal pain or an abdominal injury, such as a
knife wound.

Long-Term Outlook for Peritonitis

The outlook for peritonitis depends on the cause of your

infection and how far it had progressed before treatment

began. Medications and surgery are usually able to bring the

infection under control.
If treatment doesnt begin early, the infection can spread. If
other organs are damaged, your recovery will depend on your
overall health and how much damage was done.
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