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Peritonitis - secondary

Definition

The peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the organs in the abdomen. Peritonitis is present when this tissue becomes inflamed or infected. Secondary peritonitis is when another condition is the cause.

Causes

Secondary peritonitis has several major causes.

  • Bacteria may enter the peritoneum through a hole (perforation) in an organ of the digestive tract. The hole may be caused by a ruptured appendix, stomach ulcer, or perforated colon. It may also come from an injury, such as a gunshot or knife wound or following the ingestion of a sharp foreign body.
  • or chemicals released by the pancreas may leak into the abdominal cavity. This may be caused by called pancreatitis.
  • Tubes or catheters placed into the abdomen may cause this problem. These include catheters for peritoneal dialysis, feeding tubes, and others.

    • An infection of the bloodstream (sepsis) may lead to an infection in the abdomen also. This is a severe illness.

    This tissue may become infected when there is no clear cause.

    occurs when the lining of the intestinal wall dies and can lead to peritonitis. This problem nearly always develops in an infant who is ill or born early.

    Symptoms

    Symptoms include:

  •  when your belly area is bigger than usual
  • Decreased appetite
  • Nausea
  • Vomiting

    • Note: There may be signs of .

    Exams and Tests

    During a physical exam, the health care provider may notice abnormal with fever, and breathing, low blood pressure, and a tender distended abdomen.

    Tests may include:

  • Blood chemistry, including pancreatic enzymes
  • Complete blood count
  • Liver and kidney function tests
  • X-rays or CT scan
  • Urinalysis

    • Treatment

    Often, surgery is needed to remove or treat sources of infection. These may be an infected bowel, an inflamed appendix, or an or perforated diverticulum, usually due to diverticulitis.

    General treatment includes:

  • Antibiotics
  • Fluids through a vein (IV)
  • Pain medicines
  • Tube through the nose into the stomach or intestine (nasogastric or NG tube)

    • Outlook (Prognosis)

    The outcome can range from complete recovery to overwhelming infection and death. Factors that determine the outcome include:

  • How long the symptoms were present before treatment began
  • The person's general health

    • Possible Complications

    Complications may include:

  • Abscess
  • Gangrene (dead) bowel requiring surgery
  • Intraperitoneal (a potential cause of future bowel blockage)

    • When to Contact a Medical Professional

    Contact your provider if you have symptoms of . This is a serious condition. It needs emergency treatment in most cases.

    References

    Mathews JB, Turaga K. Surgical peritonitis and other diseases of the peritoneum, mesentery, omentum, and diaphragm. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 39.

    Privratsky AM, Barreto JC, Turnage RH, Mizell J, Badgwell B. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 44.

    Schedule An Appointment

    Contact Atlanta Obsetrics and Gynaecology at The Womens Center Millennium Hospital - 404-ATL-BABY

    GO

    Review Date: 5/4/2022

    Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.