PERITONITIS

General Information

DEFINITION--A serious infection or inflammation of part or all of the peritoneum, the covering of the intestinal tract.

BODY PARTS INVOLVED--Abdomen, including intestines and peritoneum (a thin membrane that covers all the organs and walls of the abdomen).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Pain in one area or throughout the abdomen. Pain usually starts suddenly and becomes increasingly severe. Pain may be cramp-like at first, and then steady. The patient often prefers to lie quietly on the back because movement or pressure on the abdomen increases pain.
• Shoulder pain (sometimes).
• Chills and fever (often high).
• Dizziness and weakness.
• Rapid heartbeat.
• Low blood pressure.

CAUSES--

Intense inflammation of the peritoneum lining that occurs when foreign material enters the abdominal cavity. Foreign material includes bacteria or gastrointestinal contents, such as digestive juices, blood, partly digested food or feces. These materials enter the abdomen following:

• Rupture or perforation of any organ in the abdomen, such as an inflamed appendix, peptic ulcer or infected diverticulum or gallbladder.
• Injury to the abdominal wall, such as from a knife or bullet wound.
• Pelvic inflammatory disease.
• Rupture of an ectopic pregnancy.

RISK INCREASES WITH

• Delay in treatment of causes listed above.
• Recent abdominal surgery.
• Corticosteroid therapy.
• Advanced liver disease.

HOW TO PREVENT--Obtain prompt medical treatment for underlying disorders.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory white-blood-cell count to detect inflammation, red-blood-cell count to detect bleeding and measurement of fluid and electrolyte levels.
• Surgical diagnostic procedures, such as passing a small needle into the abdomen to obtain fluid, blood or other material.
• CT scan (See Glossary) and x-rays of the abdomen.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization is usually necessary to treat this condition and any underlying problem. You may require therapy for dehydration, respiratory support and blood transfusions.
• Surgery may be necessary to repair the organ damage or injury that allowed foreign material into the abdomen.

POSSIBLE COMPLICATIONS

• Shock.
• Blood poisoning (septicemia).
• Intestinal obstruction caused by later adhesions (bands of scar tissue).
• Kidney or liver failure.

PROBABLE OUTCOME--Usually curable with early diagnosis and treatment. Treatment delay and complications can be fatal. Outcome dependent on age, duration of illness, cause and any pre-existing condition.

How To Treat

GENERAL MEASURES----Early diagnosis and treatment of the underlying disorder, such as appendicitis, ulcer or ectopic pregnancy, are essential. If abdominal pain develops, don't waste valuable time with home treatments--especially laxative use. Laxatives may cause inflamed abdominal organs to rupture.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection.
• Pain relievers (sometimes) after diagnosis or surgery.

ACTIVITY--Rest in bed after treatment until symptoms disappear. If surgery is necessary, resume your activities gradually after surgery.

DIET--Don't eat or drink anything (so the intestinal tract can rest) until the acute infection subsides. You will be given intravenous nourishment and fluids. Oral feedings will resume when your system can tolerate them.

Call Your Doctor If

• You have symptoms of peritonitis. This is an emergency!
• The following occurs during treatment: Constipation. Signs of new infection, including fever, chills, muscle aches, dizziness, headache and increasing abdominal pain.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.