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The inflammation or irritation of the peritoneum is called as peritonitis. The peritoneum is the thin tissue that covers the inner abdominal wall and the organs of the abdomen. Peritonitis is a medical emergency that requires immediate medical attention.


Peritonitis or inflammation of the peritoneum can be localized or generalized. It usually occurs as a form of infection due to the rupture of a hollow abdominal organ. In some cases, it occurs due to abdominal trauma or inflamed appendix.

There are two types of peritonitis, primary and secondary. The primary peritonitis occurs when a blood infection or lymph node infection spreads to the peritoneum. Primary peritonitis makes up less than 1% of all cases as it’s a rare condition.

Secondary peritonitis is the most common form. It usually occurs when the infection occurs due to a perforation in the abdominal wall. Peritonitis is a very serious condition and can turn fatal if not treated immediately.

Signs and Symptoms of Peritonitis

Symptoms of peritonitis include:

  • Initially the patient suffers from poor appetite and nausea
  • Dull abdominal pain that gradually turns into severe, persistent pain
  • Pain that worsens with movement
  • Abdominal tenderness
  • Abdominal distention
  • Chills
  • Fever
  • Extreme thirst
  • Diarrhea
  • Low urine output
  • Thirst
  • Fatigue
  • Inability to pass gas or stools
  • Vomiting

Patients who are undergoing peritoneal dialysis may show symptoms such as white fleck or clumps or strands in the dialysis fluid. This makes the dialysis fluid appear cloudy.

What Causes Peritonitis?

Peritonitis can happen due to a number of causes. Rupture of the abdominal wall is usually the common cause for peritonitis. At times, when peritonitis occurs without the rupture of the abdominal wall, it is called as spontaneous peritonitis.

Some of the causes of peritonitis include:

  • Abdominal injury
  • Ruptured appendix
  • Infection of the gallbladder, intestines or septicemia
  • Pelvic inflammatory disease
  • Cirrhosis of liver
  • Chron’s disease
  • Pancreatitis
  • Medical procedures such as surgery, insertion of a feeding tube, etc.
  • Diverticulitis

Diagnosis for Peritonitis

The doctor will conduct a physical examination of the patient and take down complete medical history. Most of the time, the signs and symptoms or the cloudy dialysis fluid is enough for diagnosing peritonitis. In case of secondary peritonitis or spontaneous peritonitis, the doctor may conduct the following diagnostic tests:

Peritoneal fluid analysis to check the fluid in the peritoneum for presence of bacteria or blood cell count

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Blood tests to check the rise in white blood cell count or infection

Imaging tests such as X-rays, CT scans to check for any perforations or ruptures in the abdominal wall

Treatment for Peritonitis

Peritonitis requires hospitalization of the patient. The patient is kept on an antibiotic medications to fight any infection and prevent it from spreading. In some cases, surgery is required to remove any infected tissue that is causing the infection. Other treatments include surgery of the appendix, intravenous fluids, pain medications, etc.

Those on dialysis will have to wait till the infection is cleared for further dialysis. Or else they will have to switch to another form of dialysis.

Prognosis for peritonitis depends on the cause of infection, how much and how fast it has spread. Most of the time, medications and surgery help cure the infection. However, if any organs are damaged, it will have an effect on the overall health and recovery. Call the doctor immediately in case of any severe abdominal pain, and get treatment immediately.

Written by: healthplus24.com team

Date last updated: January 20, 2015

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