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Diagnosis of Peritonitis

If you have any symptoms of peritonitis, call your doctor right away. Seeking prompt medical attention is especially important for peritoneal dialysis patients who have a combination of abdominal pain and a clouding of the peritoneal fluid, which is caused by a buildup of infection-fighting white blood cells.

Because peritonitis can rapidly lead to potentially fatal complications such as sepsis and septic shock, which causes a massive drop in blood pressure, organ failure, and death, it’s essential to receive a quick diagnosis followed by appropriate treatment.

Your doctor will ask about your symptoms and medical history, and conduct a thorough physical examination, including assessment of tension and tenderness in the abdomen.

Diagnostic tests for peritonitis may include:

  • Blood and urine tests
  • Imaging studies such as X-rays and computerized tomography (CT) scans
  • Exploratory surgery

Your doctor also may perform a paracentesis, a procedure in which fluid from the abdominal cavity is withdrawn through a thin needle and checked for infection. Paracentesis is useful for identifying primary spontaneous peritonitis and secondary peritonitis caused by pancreatitis.

Treatments for Peritonitis

If you're diagnosed with peritonitis, you'll be admitted to a hospital. Typically, you'll immediately start receiving intravenous antibiotics or antifungal medications to treat the infection. Additional supportive treatments will be necessary if organ failure from sepsis develops as a complication of the infection. Such treatments may include intravenous fluids, drugs to maintain blood pressure, and nutritional support.

If you have peritoneal dialysis-associated peritonitis, you may receive medications that are injected directly into the peritoneal tissue, a strategy that some studies have reported to be more effective than intravenous medications. Until the peritonitis is cured, you will need to use another method of dialysis, such as hemodialysis.

In many cases, emergency surgery is required, especially if peritonitis has been caused by conditions such as appendicitis, a perforated stomach ulcer, or diverticulitis. Infected tissue such as a burst appendix or abscess will be surgically removed. So will any part of the peritoneal tissue that has been seriously damaged by infection.

During your hospitalization, you will be closely monitored for signs of sepsis and septic shock, which usually require immediate transfer to an intensive care unit.

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