Peritonitis is inflammation of the peritoneum caused by a bacterial or fungal infection. The peritoneum is the tissue that lines the inner wall of the abdomen, which covers and supports the majority of the inner abdominal organs, such as the stomach and intestines.
If peritonitis is left untreated, complications may arise. For example, the infection can spread into the bloodstream—known as sepsis—and reach other organs, resulting in organ failure or even death. Due to its fatal complications, it’s crucial that symptoms are recognized early on so treatment can begin immediately.
Peritonitis comes in two types: primary spontaneous peritonitis and secondary peritonitis. Primary spontaneous peritonitis is caused by an infection in the peritoneum. Secondary peritonitis is the result of an infection or injury in the abdominal cavity, which allows infectious bacteria or fungi to enter the peritoneum.
Common risk factors of primary spontaneous peritonitis include liver disease with cirrhosis and kidney failure, which can lead to a patient getting peritoneal dialysis.
Common causes of secondary peritonitis include:
- A ruptured appendix, diverticulum or stomach ulcer
- Digestive diseases
- Pelvic inflammatory disease
- Slits of the stomach, intestine, gallbladder or appendix
- Trauma or injury to the abdomen (e.g. gunshot wound or knife stabbing)
Initial symptoms of peritonitis are similar to that of a stomach flu or food poisoning; it includes nausea, abdominal pain (that can begin dull and become severe) as well as a poor appetite. Further symptoms can include:
- Abdominal tenderness
- Fluid in the abdomen
- Extreme thirst
- Inability to pass urine or passing significantly less urine than normal
- Difficulty passing gas or having a bowel movement
A patient diagnosed with peritonitis will begin treatment in a hospital setting as it is life-threatening. Intravenous antibiotics or antifungal medications will be administered immediately. Supportive treatments to prevent and treat sepsis and protect the organs will also be conducted in order to prevent complications.
In some cases, more often than not, emergency surgery may be required in order to treat the underlying cause of peritonitis; it may include surgery for appendicitis, perforated stomach ulcers, or diverticulitis. Any infected tissue or abscess may also be removed surgically as well.
In the hospital, the patient will be closely monitored for any signs of septic shock. If it does occur, the patient will be moved to intensive care immediately.
To avoid complications associated with peritonitis it’s important to prevent it in the first place. Peritonitis can be caused by peritoneal dialysis. Although this previously was far more common with advancements in technology the risk has significantly lowered—but the risk still exists. Tips to prevent peritonitis caused by peritoneal dialysis include:
- Thoroughly washing your hands—deep between the fingers and under the fingernails—prior to touching the catheter
- Wearing a mouth/nose mask during exchanges
- Observing proper sterile techniques
- Applying antibiotic cream at the exit site of the catheter
If there is any contamination during the process, report it immediately to your doctor or medical professional so that it can be examined right away and help lower the risk of complications.