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  • Peritonitis

    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 chronic liver disease, among other conditions.
    • 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).
    Secondary Peritonitis
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    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Risk factors for peritonitis include:

    Symptoms

    Symptoms may include:
    • 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 dizziness
    • 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, and perform a physical exam. Tests may include:
    • Blood tests
    • Analysis of fluids from the peritoneum
    • Abdominal x-rays—to look for signs of inflammation
    • Laparotomy—surgery to open and examine the abdomen

    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
    If you are diagnosed with peritonitis, follow your doctor's instructions.

    Prevention

    There are no guidelines for preventing peritonitis.

    RESOURCES

    American Gastroenterological Association http://www.gastro.org

    The American College of Gastroenterology http://www.acg.gi.org

    CANADIAN RESOURCES

    Canadian Association of Gastroenterology http://www.cag-acg.org

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

    References

    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.com/health/peritonitis/ds00990. Updated July 2009. Accessed July 24, 2009.

    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.

    Revision Information

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