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Peritonitis - spontaneous bacterial

Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - 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.

Spontaneous bacterial peritonitis (SBP) is present when this tissue becomes infected and there is no clear cause.

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Peritoneal sample

Causes

SBP is most often caused by infection in fluid that collects in the peritoneal cavity (ascites). The fluid buildup often occurs in people with advanced liver or kidney disease.

Risk factors for liver disease include:

SBP also occurs in people who are on peritoneal dialysis for kidney failure.

Peritonitis may have other causes in which case it is called secondary peritonitis. These include infection from other organs or leakage of enzymes or other toxins into the abdomen.

Symptoms

Symptoms include:

Other symptoms include:

Exams and Tests

Tests will be done to check for infection and other causes of abdominal pain:

Treatment

Treatment depends on the cause of the SBP.

You will need to stay in the hospital so health care providers can rule out other causes such as a ruptured appendix and diverticulitis.

Outlook (Prognosis)

In most cases, the infection can be treated. However, kidney or liver disease may limit recovery.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have symptoms of peritonitis. This can be a medical emergency situation.

Prevention

Steps should be taken to prevent infection in people with peritoneal catheters.

Long-term antibiotics may be used:

Related Information

Ascites
Cirrhosis
Abscess
Intestinal obstruction and Ileus
Hepatorenal syndrome
Loss of brain function - liver disease
Sepsis

References

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.

Kuemmerle JF. Inflammatory and anatomic diseases of the intestine, peritoneum, mesentery, and omentum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 128.

Sola E, Gines P. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 93.

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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.

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