Peritonitis - secondarySecondary peritonitis
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.
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 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 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 (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.Read Article Now Book Mark Article
- Swollen abdomen when your belly area is bigger than usual
- Abdominal pain
- Decreased appetite
- Low urine output
Note: There may be signs of 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 Article
Exams and Tests
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 Article
Rapid 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 Article
Tests may include:
- Blood culture
- Blood chemistry, including pancreatic enzymes
- Complete blood count
- Liver and kidney function tests
- X-rays or CT scan
- Peritoneal fluid culture
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.
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 Article
General treatment includes:
- Fluids through a vein (IV)
- Pain medicines
- Tube through the nose into the stomach or intestine (nasogastric or NG tube)
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
Complications may include:
- Gangrene (dead) bowel requiring surgery
- Intraperitoneal adhesions (a potential cause of future bowel blockage)
- Septic shock
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 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 Article
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: 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.