Peritonitis Health Dictionary

Inflammation of the peritoneum. Peritonitis is a serious, usually acute, condition. The most common cause is perforation of the stomach or intestine wall, which allows bacteria and digestive juices to move into the abdominal cavity. Perforation is usually the result of a peptic ulcer, appendicitis, or diverticulitis. Peritonitis may also be associated with acute salpingitis, cholecystitis, or septicaemia.

There is usually severe abdominal pain. After a few hours, the abdomen feels hard, and peristalsis stops (see ileus, paralytic). Other symptoms are fever, bloating, nausea, and vomiting.

Diagnosis is made from a physical examination. Surgery may be necessary to deal with the cause. If the cause is unknown, a laparoscopy or an exploratory laparotomy may be performed. Antibiotic drugs and intravenous infusions of fluid are often given. In most cases, a full recovery is made. Intestinal obstruction, caused by adhesions, may occur at a later stage.

In?ammation of the PERITONEUM. It may be acute or chronic, localised or generally di?used, and its severity and danger may vary according to the cause.

Acute peritonitis generally arises because bacteria enter the peritoneal cavity, from penetrating wounds, e.g. stabs, from the exterior or from the abdominal organs. Hence conditions leading to perforation of the STOMACH, INTESTINE, BILE DUCT, URINARY BLADDER, and other hollow organs such as gastric ulcer (see STOMACH, DISEASES OF), typhoid fever (see ENTERIC FEVER), gall-stones (see under GALLBLADDER, DISEASES OF), rupture of the bladder, strangulated HERNIA, and obstructions of the bowels, may lead to peritonitis. Numerous bacteria may cause the in?ammation, most common being E. coli, streptococci and the gonococcus.

The symptoms usually begin with a RIGOR together with fever, vomiting, severe abdominal pain and tenderness. Shock develops and the abdominal wall becomes rigid. If untreated the patient usually dies. Urgent hospital admission is required. X-ray examination may show gas in the peritoneal cavity. Treatment consists of intravenous ?uids, antibiotics and surgical repair of the causative condition. Such treatment, together with strong analgesics is usually successful if started soon enough.

n. inflammation of the *peritoneum. Primary peritonitis is caused by bacteria spread via the bloodstream: examples are pneumococcal peritonitis and tuberculous peritonitis. Symptoms are diffuse abdominal pain and swelling, with fever and weight loss. Fluid may accumulate in the peritoneal cavity (see ascites) or the infection may complicate existing ascites (see spontaneous bacterial peritonitis). Secondary peritonitis is due to perforation or rupture of an abdominal organ (for example, a duodenal ulcer, the gall bladder, or the vermiform appendix), allowing access of bacteria and irritant digestive juices to the peritoneum. This produces sudden severe abdominal pain, first at the site of rupture but later becoming generalized. Shock develops, and the abdominal wall becomes rigid; X-ray examination may reveal gas within the peritoneal cavity. Treatment is usually by surgical repair of the perforation, but in some cases conservative treatment using antibiotics and intravenous fluid may be used. *Subphrenic abscess is a possible complication. Meconium peritonitis occurs in newborn infants as a result of a perforated intestine; it is initially a sterile contamination of the peritoneum.