What are symptoms of peritonitis?

Answer 1

The main manifestations of peritonitis are acute abdominal pain, tenderness, and guarding, which are exacerbated by moving the peritoneum, e.g. coughing, flexing the hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits pain, but releasing the hand abruptly will aggravate the pain, as the peritoneum snaps back into place). The localisation of these manifestations depends on whether peritonitis is localised (e.g. appendicitis or diverticulitis before perforation), or generalised to the whole abdomen; even in the latter case, pain typically starts at the site of the causing disease. Peritonitis is an example of acute abdomen. * Diffuse abdominal rigidity ("washboard abdomen") is often present, especially in generalised peritonitis; * Fever; * Sinus tachycardia; * Development of ileus paralyticus (i.e. intestinal paralysis), which also causes nausea and vomiting; * Sequestration of fluid and electrolytes, as revealed by decreased central venous pressure, may cause electrolyte disturbances, as well as significant hypovolaemia, possibly leading to shock and acute renal failure. * A peritoneal abscess may form (e.g. above or below the liver, or in the lesser omentum). * Sepsis may develop, so blood cultures should be obtained. * the fluid may push on the diaphragm and cause breathing difficulties [1]

1. http://en.wikipedia.org/wiki/Peritonitis

Answer 2

Peritonitis is defined as inflammation of the peritoneum (the serous membrane which lines part of the abdominal cavity and some of the viscera it contains). It may be localised or generalised, generally has an acute course, and may depend on either infection (often due to rupture of a hollow viscus) or on a non-infectious process. Peritonitis generally represents a surgical emergency.1 1. http://en.wikipedia.org/wiki/Peritonitis

Answer 3

Definition

Peritonitis is swelling (inflammation) of the peritoneum -- the tissue that lines the wall of the abdomen and covers the abdominal organs.

Alternative Names

Spontaneous bacterial peritonitis (SBP)

Causes, incidence, and risk factors

Spontaneous peritonitis is usually caused by ascites, a collection of fluid in the peritoneal cavity. This usually occurs from liver or kidney failure.

Risk factors for liver disease include alcoholic cirrhosis and other diseases that lead to cirrhosis, such as viral hepatitis (Hepatitis B or C).

Spontaneous peritonitis also occurs in patients who are on dialysis for kidney failure.

Symptoms

• Abdominal painand bloating
• Abdominal tenderness
• Fever
• Fluid in the abdomen
• Low urine output

Other symptoms include:

• Chills
• Joint pain
• Nausea and vomiting

Signs and tests

Tests that show infection:

• Blood culture
• Cell studies (cytologic examination) of peritoneal fluid
• Chemical examination of peritoneal fluid
• Culture of peritoneal fluid
• Peritoneal fluid analysis (paracentesis)

Other tests:

• Abdominal imaging studies (to rule out other causes of abdominal pain)
• WBC (nuclear) scan

Treatment

Treatment depends on the cause of the peritonitis.

• Surgery may be needed if peritonitis is caused by a foreign object, such as a catheter used in peritoneal dialysis.
• Antibiotics may control infection in cases of spontaneous peritonitis with liver or kidney disease.
• Intravenoustherapy can treat dehydration.

You may need to stay in the hospital so health care providers can rule out other causes of peritonitis, such as appendicitis and diverticulitis.

Expectations (prognosis)

The infection can usually be treated. However, kidney or liver disease may limit recovery.

Complications

• Abscess
• Hepatic encephalopathy
• Hepatorenal syndrome
• Intestinal obstruction from scar tissue
• Sepsis

Calling your health care provider

Call your health care provider if you have symptoms of peritonitis. This can quickly become an emergency situation.

Prevention

Patients with peritoneal catheters should be treated with sterile techniques. In cases of liver failure, antibiotics may help prevent peritonitis from coming back.

References

Runyon BA. Ascites and Spontaneous Bacterial Peritonitis. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 88.

Answer 4

Definition

Peritonitis is an inflammation (irritation) of the peritoneum, the tissue that lines the wall of the abdomen and covers the abdominal organs.

Alternative Names

Acute abdomen

Causes, incidence, and risk factors

A collection of pus in the abdomen, called an intra-abdominal abscess, may cause peritonitis.

See the specific types of peritonitis:

• Peritonitis - spontaneous
• Peritonitis - secondary
• Peritonitis - dialysis associated

Symptoms

• Abdominal distention
• Abdominal painor tenderness
• Fever
• Fluid in the abdomen
• Inability to pass feces or gas
• Low urine output
• Nausea and vomiting
• Point tenderness
• Thirst

Additional symptoms that may be associated with this disease include:

• Cloudy dialysis fluid (if undergoing peritoneal dialysis)
• Nausea and vomiting
• Shaking chills
• Signs of shock

Signs and tests

The doctor will perform a physical exam. The abdomen is usually tender, and may feel firm and "board-like." The patient may extensively "guard" the area, using protective movements such as curling up or refusing to allow the area to be touched.

Blood tests, x-rays, and CT scans may be ordered.

Treatment

The cause must be identified and treated promptly. Treatment typically involves surgery and antibiotics.

Expectations (prognosis)

With treatment, patients usually do well. Without treatment, the outcome is usually poor. However, in some cases, patients do poorly even with prompt and appropriate treatment.

Complications

Peritonitis can be life threatening and may cause a number of different complications. Complications depend on the specific type of peritonitis.

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of peritonitis.

Prevention

Prevention depends on the cause. See the specific types of peritonitis.

References

Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum, and Retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2008:chap 43.

Answer 5

Definition

Peritonitis is inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs.

Alternative Names

Spontaneous bacterial peritonitis (SBP)

Causes, incidence, and risk factors

Spontaneous peritonitis is usually caused by infection of ascites, a collection of fluid in the peritoneal cavity. This usually occurs from liver or kidney failure.

Risk factors for liver disease include excessive alcohol use and other diseases that lead to cirrhosis, such as chronic viral hepatitis (hepatitis B or hepatitis C ).

Spontaneous peritonitis also occurs in patients who are on dialysis for kidney failure.

Symptoms

• Abdominal painand bloating
• Abdominal tenderness
• Fever
• Low urine output

Other symptoms include:

• Chills
• Joint pain
• Nausea and vomiting

Signs and tests

Tests will be done to check for infection and rule out other causes of abdominal pain:

• Blood culture
• White blood cell count in a sample of peritoneal fluid
• Chemical examination of peritoneal fluid
• Culture of peritoneal fluid
• CT scan or ultrasound of the abdomen

Treatment

Treatment depends on the cause of the peritonitis.

• Surgery may be needed if peritonitis is caused by a foreign object, such as a catheter used in peritoneal dialysis.
• Antibiotics may control infection in cases of spontaneous peritonitis with liver or kidney disease.
• Intravenoustherapy can treat dehydration.

You may need to stay in the hospital so health care providers can rule out other causes of peritonitis, such as appendicitis and diverticulitis.

Expectations (prognosis)

The infection can usually be treated. However, kidney or liver disease may limit recovery.

Complications

• Hepatic encephalopathy
• Hepatorenal syndrome
• Sepsis

Calling your health care provider

Call your health care provider if you have symptoms of peritonitis. This can quickly become an emergency situation.

Prevention

Patients with peritoneal catheters should be treated with sterile techniques. In cases of liver failure, antibiotics may help prevent peritonitis from coming back.

References

Garcia-Tiso G. Cirrhosis and its sequellae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 157.

Prather C. Inflammatory and anatomic diseases of the intestine, peritoneum, mesentery, and omentum. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 145.

Reviewed By

Review Date: 07/07/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 6

Definition

Peritonitis is an inflammation (irritation) of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs.

Alternative Names

Acute abdomen

Causes, incidence, and risk factors

A collection of pus in the abdomen, called an intra-abdominal abscess, may cause peritonitis.

See the specific types of peritonitis:

• Peritonitis - spontaneous
• Peritonitis - secondary

Symptoms

The belly (abdomen) is very painful or tender. The pain may become worse when the belly is touched or when you move.

Your belly may look or feel bloated. This is called abdominal distention.

Other symptoms may include:

• Fever and chills
• Fluid in the abdomen
• Passing few or no stools or gas
• Excessive fatigue
• Passing less urine
• Nausea and vomiting

Signs and tests

The doctor will perform a physical exam. The abdomen is usually tender, and may feel firm and "board-like." The patient may "guard" the area by tightening the stomach muscles when examined, curling up, or refusing to allow the area to be touched.

Blood tests, x-rays, and CT scans may be ordered. If there is a lot of fluid in the belly area, the doctor may use a needle to remove some and send it for testing.

Treatment

The cause must be identified and treated promptly. Treatment typically involves surgery and antibiotics.

Complications

Peritonitis can be life threatening and may cause a number of different complications. Complications depend on the specific type of peritonitis.

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of peritonitis.

Prevention

Prevention depends on the cause. See the specific types of peritonitis.

References

Turnage RH, Richardson KA, Li BD, McDonald JC. Abdominal Wall, Umbilicus, Peritoneum, Mesenteries, Omentum, and Retroperitoneum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. St. Louis, Mo: WB Saunders; 2008:chap 43.

Reviewed By

Review Date: 06/10/2010

Shabir Bhimji MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland , TX Review provided by VeriMed Healthcare Network. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 7

Peritonitis is an infection of the peritoneum that can develop in several ways.