Peritonitis - secondary
Secondary peritonitisThe 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.
- Bile or chemicals released by the pancreas may leak into the abdominal cavity. This may be caused by swelling and inflammation of the pancreas called pancreatitis.
Bile
Bile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...
Read Article Now Book Mark ArticleSwelling and inflammation of the pancre...
Acute pancreatitis is sudden swelling and inflammation of the pancreas.
Read Article Now Book Mark Article - 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.
Necrotizing enterocolitis 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.
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
Read Article Now Book Mark ArticleSymptoms
Symptoms include:
- Swollen abdomen when your belly area is bigger than usual
Swollen abdomen
A swollen abdomen is when your belly area is bigger than usual.
Read Article Now Book Mark Article - Abdominal pain
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
Read Article Now Book Mark Article - Decreased appetite
- Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
Read Article Now Book Mark Article - Low urine output
Low urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...
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- Thirst
Thirst
Excessive thirst is an abnormal feeling of always needing to drink fluids.
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Note: There may be signs of shock.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
Read Article Now Book Mark ArticleExams and Tests
During a physical exam, the health care provider may find abnormal vital signs with fever, rapid heart rate and breathing, low blood pressure, and a tender distended abdomen.
Vital signs
Vital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...
Read Article Now Book Mark ArticleRapid heart rate
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
Read Article Now Book Mark ArticleTests may include:
- Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Read Article Now Book Mark Article - Blood chemistry, including pancreatic enzymes
- Complete blood count
- Liver and kidney function tests
- X-rays or CT scan
- Peritoneal fluid culture, Gram stain and chemistry tests
Peritoneal fluid culture
Peritoneal fluid culture is a laboratory test performed on a sample of peritoneal fluid. It is done to detect bacteria or fungi that cause infection...
Read Article Now Book Mark Article - Urinalysis
Treatment
Often, surgery is needed to remove or treat sources of infection. These may be an infected bowel, an inflamed appendix, or an abscess or perforated diverticulum, usually due to diverticulitis.
Abscess
An abscess is a collection of pus in any part of the body. In most cases, the area around an abscess is swollen and inflamed.
Read Article Now Book Mark ArticleGeneral 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 adhesions (a potential cause of future bowel blockage)
Adhesions
Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
Read Article Now Book Mark Article - Septic shock
Septic shock
Septic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.
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When to Contact a Medical Professional
Contact your provider if you have symptoms of peritonitis. This is a serious condition. It needs emergency treatment in most cases.
Peritonitis
Peritonitis is an inflammation (irritation) of the peritoneum. This is the thin tissue that lines the inner wall of the abdomen and covers most of t...
Read Article Now Book Mark ArticleReferences
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.
Review Date: 6/11/2024
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.