Peritonitis

Overview

Peritonitis is the inflammation of the peritoneum. Peritoneum is the tissue lining of your abdominal cavity. If the tissues are exposed to bodily fluids that are irritating or infectious, they may become inflamed. 

Peritonitis typically occurs when something inside the abdomen leaks or breaks. Infection is the most common cause and can be very dangerous. Since the peritoneum extends throughout the abdomen and comes into contact with many organs, infections in the peritoneum can affect all these organs. Additionally, the infection can spread to the bloodstream and become systemic, impacting the entire body.

Peritonitis occurs in two different types: 

• Spontaneous bacterial peritonitis: Bacteria are the cause of this condition. Patients with kidney problems or liver disease, such as cirrhosis, may experience it.

Spontaneous bacterial peritonitis is a type or peritonitis that develops in the absence of a hole or tear. Abdominal fluid accumulation is a common symptom of advanced cirrhosis. The accumulation of fluid could potentially result in a bacterial infection. 

• Secondary peritonitis: An abdominal organ rupture can result in peritonitis. Or it might be brought on by other medical problems.

Peritoneal dialysis, a common treatment for kidney failure, can sometimes cause peritonitis. This treatment aids in the removal of waste products from the blood when the kidneys are unable to do so independently. To prevent peritonitis in individuals undergoing peritoneal dialysis, maintaining proper hygiene before, during, and after the procedure is essential. This includes thorough cleansing of the catheter site and regular handwashing practices. By adhering to these precautions, the risk of peritonitis can be minimized.

It is crucial to promptly address peritonitis, an infection that can lead to severe complications if left untreated. Healthcare professionals are equipped to manage this condition along with any underlying medical issues. Typically, antibiotics are administered to combat the bacterial infection associated with peritonitis. In some cases, surgical intervention may be necessary.

Symptoms

The following sign and symptoms of peritonitis include:

• Abdominal pain or tenderness.
• Bloating or fullness of the abdomen.
• Diarrhea.
• Inability to pass gas or feces.
• Nausea and vomiting.
• Fever.
• Loss of appetite.
• Confusion.
• Thirsty.
• Decreased in urine.
• Tiredness.

Signs and symptoms of peritonitis associated with peritoneal dialysis may also include:

• Dialysis fluid that is cloudy.
• Fibrin, referred to as white flecks, strands, or clumps, in the dialysis fluid.

Delaying treatment for peritonitis can escalate into a life–threatening situation. It is crucial to promptly contact your healthcare provider if you notice symptoms such as severe abdominal pain, bloating, or a feeling of fullness along with: 

• Decreased in urine.
• Fever.
• Inability to pass gas or feces.
• Nausea and vomiting.
• Thirsty.

Contact your healthcare provider as soon as possible if your peritoneal dialysis fluid:

• Cloudy or has an unusual color.
• Consists of clumps or strands.
• It contains white flecks. 
• Odd smell, particularly if you have pain or color changes in the area surrounding your catheter.

Immediate medical attention is imperative if you encounter severe stomach pain. Peritonitis can arise from various causes such as a ruptured appendix or a significant abdominal injury. The intensity of the pain may render you unable to find a comfortable position or remain still.

Causes

An organ rupture in the abdomen, such as that of the stomach or colon, is typically the source of peritoneum infection. Peritonitis seldom results from other causes.

The following are common causes of rupture that result in peritonitis:

• Medical procedures:
  • Waste materials are taken out of the blood through catheters during peritoneal dialysis. Poor sanitation, contaminated equipment, or an unclean treatment room can all lead to an infection during peritoneal dialysis.
  • Peritonitis can also occur following gastrointestinal surgery.
  • Peritonitis can occur during an abdominal fluid extraction, such as a procedure for liver disease–related ascites.
  • The use of feeding tubes can result in peritonitis.
  • A colonoscopy, a test used to examine the inside of the rectum and colon, may occasionally result in complications.
  • Following an endoscopy, a technique used to examine the digestive tract, peritonitis may develop.
• Organ rupture: Bacteria can enter the peritoneum through an opening in your digestive tract.
• Pancreatitis: This is an inflammation of the pancreas. Bacteria may spread outside the pancreas in people with pancreatitis who get an infection.
• Diverticulitis: Peritonitis may result from an infection of small, protruding pouches in the digestive system. Should one of the pouches rupture, this is what would occur. Waste from the intestines could leak into the abdomen through the ruptured pouch.
• Trauma: Peritonitis can result from injury. This may make it possible for chemicals or bacteria to enter your peritoneum from other areas of your body.

Risk factors

The following increases the risk of peritonitis:

• History of peritonitis: If you’ve ever experienced peritonitis, there’s a chance it will happen to you again more often than usual.
• Peritoneal dialysis: Patients receiving this peritoneal dialysis may develop peritonitis.
• Other medical conditions: Your chance of developing peritonitis is increased by certain illnesses, including:
  • Appendicitis.
  • Crohn’s disease.
  • Diverticulitis.
  • Liver cirrhosis.
  • Pancreatitis.
  • Stomach ulcers.