Digestive Disorders Health Center

Peritonitis

Peritonitis is an inflammation of the peritoneum, the tissue that lines the inner wall of the abdomen and covers and supports most of your abdominal organs. Peritonitis is usually caused by infection from bacteria or fungi.

Left untreated, peritonitis can rapidly spread into the blood (sepsis) and to other organs, resulting in multiple organ failure and death. So if you develop any of the symptoms of peritonitis -- the most common of which is severe abdominal pain -- it's essential to seek prompt medical evaluation and treatment that can prevent potentially fatal complications.

Symptoms of Peritonitis

The first symptoms of peritonitis are poor appetite and nausea, and a dull abdominal ache that quickly turns into persistent, severe abdominal pain, which is worsened by any movement.

Other signs and symptoms related to peritonitis may include:

• Abdominal tenderness or distention
• Chills
• Fever
• Fluid in the abdomen
• Extreme thirst
• Not passing any urine, or passing significantly less urine than usual
• Difficulty passing gas or having a bowel movement
• Vomiting

Causes of Peritonitis

The two main types of peritonitis are primary spontaneous peritonitis, an infection that develops in the peritoneum; and secondary peritonitis, which usually develops when an injury or infection in the abdominal cavity allows infectious organisms into the peritoneum. Both types of peritonitis are life-threatening. The death rate from peritonitis depends on many factors, but can be as high as 50% in those who also have cirrhosis. As many as 10% may die from secondary peritonitis.

The most common risk factors for primary spontaneous peritonitis include:

Liver disease with cirrhosis. Such disease often causes a buildup of abdominal fluid (ascites) that can become infected.

Kidney failure getting peritoneal dialysis. This technique, which involves the implantation of a catheter into the peritoneum, is used to remove waste products in the blood of people with kidney failure. It's linked to a higher risk of peritonitis due to accidental contamination of the peritoneum by way of the catheter.

Common causes of secondary peritonitis include:

• A ruptured appendix, diverticulum, or stomach ulcer
• Digestive diseases such as Crohn's disease and diverticulitis
• Pancreatitis
• Pelvic inflammatory disease
• Perforations of the stomach, intestine, gallbladder, or appendix
• Surgery
• Trauma to the abdomen, such as an injury from a knife or gunshot wound

Noninfectious causes of peritonitis include irritants such as bile, blood, or foreign substances in the abdomen, such as barium.