Peritonitis

The peritoneum can become inflamed for a variety of reasons. Infections cause most cases of peritonitis. Peritonitis is quite painful, and often indicates the presence of a serious disease.

Symptoms of peritonitis can vary depending on the underlying cause of the condition. Most of the time symptoms include:

• abdominal distress, which can include excruciating abdominal pain
• tenderness of the belly when it is touched
• nausea and vomiting
• fever
• absence of bowel movements
• loss of appetite
• shock and possibly death

Most often, peritonitis is caused by an infection inside the abdomen, usually from a portion of the intestine. For example, appendicitis or other bowel infections (diverticulitis) can cause the problem.

Other types of inflammation can also cause peritonitis without the presence of an infection. One of these is inflammation of gall bladder, known as cholecystitis. Inflammation due to chemical irritants may be another cause.

Peritonitis can also be caused by irritation of the peritoneum from bleeding in the abdominal cavity, such as from a ruptured ovarian cyst.

Depending on the cause, sometimes antibiotics (with diverticulitis) or surgery (for appendicitis) can prevent a bowel problem from leading to peritonitis.

The healthcare provider will take a person's medical history and perform a physical exam. Sometimes further tests are needed to determine the underlying cause. These may include blood tests, specific x-rays (like an abdominal CT scan) and surgery for an abdominal exploration.

The long term effects of the disease depend on the underlying cause. For example, peritonitis that stems from a ruptured ovarian cyst or appendix that is removed surgically will probably not have any long-term effects.

If the condition is the result of a serious infection, it may cause scarring of the peritoneum, possibly blockage of the bowel (obstruction), and/or death.

There are no risks to others except in unusual circumstances wherein peritonitis is a result of a transmissible infectious agent (like gonorrhea).

Treatment will depend on the cause of the condition. In mild cases, a person may need only rest and intravenous fluids. In severe cases, medications and urgent surgery may be needed to prevent death (removing a dead portion of bowel or an inflamed appendix).

Medications can cause side effects such as allergic reactions, stomach upset, and other symptoms. Specific side effects depend on the medication used. The contrast or dye used for CT scan can harm the kidneys. Surgery carries the risks of bleeding, infection, and death.

No further treatment will be needed if the cause is corrected. For example, peritonitis brought on by an infected appendix will usually be cured by an appendectomy, or surgical removal of the appendix. Some diseases that cause peritonitis (Crohn's disease, for example) can recur however.

The cause of the condition will determine how it is followed. Methods include:

• blood tests, such as a complete blood count or CBC (to check for bleeding and/or inflammation)
• physical exams
• tracking of symptoms (better or worse)
• x-rays, including abdominal x-rays and CT scans