Massachusetts General Hospital

Peritonitis

What is peritonitis?

Peritonitis is an infection caused by an inflammation of the lining of the abdominal cavity, known as the peritoneum. The peritoneum, a thin, clear membrane, normally covers all the abdominal organs and the inside walls of the abdomen.

What causes peritonitis?

Most often, peritonitis is caused by the introduction of an infection from a perforation of the bowel such as a ruptured appendix or diverticulum. Other sources include perforations of the stomach, intestine, gallbladder, or appendix. Pelvic inflammatory disease in women is also a common cause of peritonitis. Peritonitis can also develop after surgery if bacteria enters into the abdomen during an operation.

What are symptoms of peritonitis?

The following are the most common symptoms of peritonitis. However, each individual may experience symptoms differently. Symptoms may include:

• Severe abdominal pain, aggravated by any motion

• Nausea and vomiting

• Fever

• Abdominal tenderness or distention

• Fluid in the abdomen

• Unable to have a bowel movement or pass gas

• Low urine output

• Thirst

The symptoms of peritonitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is peritonitis diagnosed?

Quick diagnosis of peritonitis is vital as complications can occur quickly. In addition to a complete medical history and physical examination (which may show abdominal tension and tenderness), diagnostic tests for peritonitis may include the following:

• X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• Laboratory tests. These tests are done to identify the infectious organism.

• Exploratory surgery

• CT scans

Treatment for peritonitis

Specific treatment for peritonitis will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the condition

• Your tolerance of specific medicines, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Treatment of peritonitis is generally aimed at treating the underlying condition. Often, emergency exploratory surgery is needed, especially when appendicitis, a perforated peptic ulcer, or diverticulitis may be the cause of the infection. Prompt treatment is extremely important as major complications can occur quickly. Once peritonitis has been diagnosed, antibiotics are given immediately. Peritonitis can be fatal if not treated right away.