DOC I HAVE PERITONITIS
What is Peritonitis?
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.
What are the causes of Peritonitis?
Peritonitis is caused by a collection of blood, body fluids, or pus in the abdomen (intra-abdominal abscess).
Non infective causes:
1. Endometriosis – sterile blood clots escapes during the period of menstruation
2. Gastric juice – sterile gastric acid may escape from a perforated gastric ulcer or cancer
3. Urine – can escape from the bladder during injury to the bladder
4. Bile or chemicals released by the pancreas (pancreatic enzymes) leak into the lining of the abdominal cavity.
Although initially sterile the body fluid may become infected once they leak of their organs.
1. Spontaneous peritonitis is usually caused by infection of ascites a collection of fluid in the peritoneal cavity.
This usually occurs from severe liver such as Hepatitis B or C
2. Spontaneous peritonitis also occurs in patients who are on peritoneal dialysis for kidney failure.
3. Peritonitis may also occur due to inflammation, infection, or injury of the intestines such as appendicitis or diverticulitis.
4. Bacteria may enter the peritoneum through a hole (perforation) in the gastrointestinal tract such as by a ruptured appendix, stomach ulcer, perforated colon, or injury, such as a gunshot or knife wound.
5. Foreign contaminants can also cause secondary bacterial peritonitis if they get into the peritoneal cavity. This can occur during use of peritoneal dialysis catheters or feeding tubes.
6. Inflammation of the peritoneal cavity caused by bacteria can result in infection of the bloodstream (sepsis) and severe illness.
7. Secondary peritonitis can also affect premature babies who have necrotizing enterocolitis.
What are the symptoms of Peritonitis?
1. very painful abdomen or tender abdomen
The pain may become worse when the abdomen is palpated or when there is movement.
2. abdominal distention – the abdomen is bloated.
Other symptoms may include:
3. Fever and chills
4. Fluid in the abdomen
5. Passing little or no stools or gas
6. Excessive fatigue
7. Passing less urine
8. Nausea and vomiting
9. Racing heartbeat
10. Shortness of breath
How is Peritonitis diagnosed?
1. The abdomen is usually tender.
It may feel firm or “board-like.”
Persons with peritonitis usually curl up or refuse to let anyone touch the area.
2. Blood tests,
3. X-rays of abdomen may reveal dilated, edematous intestines
X-rays are mainly useful to look for gas below the diaphragm which suggest of gastrointestinal perforation.
4. CT scans of abdomen may be done.
5. Biopsy of the abdominal fluid
What are the complications of Peritonitis?
Peritonitis is life threatening and may cause a number of different complications:
1. loss of fluid and electrolyte with low blood volume
3. Renal Failure
What is the treatment of Peritonitis?
The cause must be identified and treated promptly.
Treatment typically involves
1. General supportive measures such as
a. vigorous intravenous rehydration
b. correction of electrolyte disturbances
2. antibiotics –
is given intravenously or into the peritoneum.
It is particularly effective against spontaneous bacterial peritonitis.
3. surgery –
laparotomy is needed to perform a full exploration and lavage of the peritoneum, as well as to correct any damage that may have caused peritonitis
What are the Preventive measures for Peritonitis?
Prevention depends on the cause.