peritonitis

Peritonitis is a serious medical condition characterized by inflammation in the peritoneum, which is the tissue that lines the abdominal cavity and covers the abdominal organs.

Causes of Peritonitis

Peritonitis can be caused by various factors, including:

• Bacterial infections: Spontaneous bacterial peritonitis (SBP) is a type of peritonitis caused by a collection of bacteria in the belly.
• Collection of blood, body fluids, or pus: A buildup of these substances in the abdominal cavity can lead to inflammation and infection.
• Intra-abdominal processes: Other conditions such as appendicitis, diverticulitis, or bowel obstruction can also cause peritonitis.

Symptoms of Peritonitis

The symptoms of peritonitis can include:

• Abdominal pain or tenderness
• Bloating or a feeling of fullness in the abdomen
• High temperature (38C or above)
• Abdominal guarding and rigidity

Definition of Peritonitis

Peritonitis is defined as an inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein.

According to various medical sources [1, 4, 5, 7, 8], peritonitis can be a potentially fatal condition if left untreated. It's essential to seek immediate medical attention if symptoms persist or worsen over time.

References: [1] Apr 6, 2023 — Symptoms of peritonitis include: Belly pain or tenderness. Bloating or a feeling of fullness in the abdomen. [4] Nov 14, 2023 — Peritonitis - a potentially fatal inflammation of the abdomen's lining - including its causes, symptoms, and treatments. [5] Oct 16, 2024 — Peritonitis is defined as an inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. [7] Peritonitis is inflammation of the peritoneum caused by several intra-abdominal processes. Clinical signs include abdominal pain, guarding, and rigidity, and ... [8] Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs.

Peritonitis is a serious condition that can cause a range of symptoms, which can vary in severity and duration. Here are some common signs and symptoms of peritonitis:

• Abdominal pain: This is one of the most common symptoms of peritonitis, ranging from mild to severe and constant. The pain may be dull or sharp, and can be felt in the upper or lower abdomen.
• Fever: A high temperature (fever) is often present in people with peritonitis, which can range from mild to severe.
• Inability to break wind or pass stools: This symptom occurs when the intestines become inflamed and are unable to function properly.
• Nausea and vomiting: Many people experience nausea and vomiting due to the inflammation and infection caused by peritonitis.
• Shock: In severe cases, peritonitis can lead to shock, which is a life-threatening condition that requires immediate medical attention.

Additionally, some other symptoms of peritonitis may include:

• Swelling and tenderness in the abdomen
• Loss of appetite
• Thirst
• Fatigue
• Diarrhea or constipation

It's essential to seek medical attention immediately if you experience any of these symptoms, as prompt treatment can help prevent complications and improve outcomes.

References: [1] - Severe abdominal pain and sensitivity to touch are typical symptoms of peritonitis. [2] [3] - Symptoms include severe and constant abdominal pain, fever, inability to break wind or pass stools, nausea and vomiting, and shock. [4] - Tummy pain, high temperature, rapid heartbeat, and other symptoms can indicate peritonitis. [5] - Common symptoms of peritonitis include abdominal discomfort, nausea and vomiting, loss of appetite, diarrhea, constipation, fever, fatigue, and swelling in the abdomen. [7] - Swelling and tenderness in the abdomen with pain ranging from dull aches to severe, sharp pain, fever and chills, loss of appetite, thirst are signs and symptoms of peritonitis.

Peritonitis can be diagnosed through various tests, including:

• Physical examination: A physical exam may reveal a hard and painful abdomen, which can indicate the presence of peritonitis [6].
• Blood tests: Blood tests can help identify infection and inflammation in the body, which is often associated with peritonitis [9].
• Imaging tests: Imaging tests such as CT scans and X-rays can show any perforations or holes in the peritoneum, which can lead to peritonitis [8][9].
• Fluid analysis: Analyzing the fluid from a paracentesis (a procedure where fluid is drawn out with a needle) can help confirm the presence of peritonitis and identify the specific infection [2][3].
• Diagnostic laparoscopy: This minimally invasive surgical procedure can provide an accurate diagnosis of surgical peritonitis while also providing a better understanding of the underlying condition [7].

It's worth noting that the single best predictor of spontaneous bacterial peritonitis (SBP) is an ascitic fluid neutrophil count of greater than 250 cells/mm^3, as indicated by peritoneal fluid analysis [3].

Peritonitis, an inflammation of the peritoneum (the thin layer of tissue covering the abdominal organs), requires prompt and effective treatment to prevent serious complications.

Antibiotic Therapy

The primary treatment for peritonitis is antibiotic therapy. The choice of antibiotics depends on the severity and type of infection, as well as any underlying medical conditions. According to various sources [1][3], empiric antimicrobial therapy typically involves the use of broad-spectrum antibiotics such as cefotaxime, gentamicin, ampicillin, and sulfamethoxazole.

Specific Antibiotics Used

In some cases, specific antibiotics may be used to treat peritonitis. For example:

• Third-generation cephalosporins like ceftazidime (Fortaz, Tazicef) [4] are often used to treat peritonitis caused by gram-negative bacteria.
• The combination of a first-generation cephalosporin with an aminoglycoside was previously recommended as the empirical treatment for PD-related peritonitis [7].

Treatment Approach

The treatment approach for peritonitis typically involves:

• Intravenous antibiotics or antifungal medications to treat the infection [8]
• Surgery may be necessary to remove infected tissue and repair any damage to the abdominal organs [2]

It is essential to seek medical attention immediately if symptoms of peritonitis occur, as prompt treatment can help prevent serious complications.

References: [1] Oct 15, 2024 — Amoxicillin/clavulanic acid. Cefuroxime + metronidazole ; Piperacillin/tazobactam. Third- or fourth-generation cephalosporin + metronidazole. [2] Apr 6, 2023 — Treatment · Antibiotics. You'll likely take antibiotic medicine through a needle in a vein. · Surgery. This is often needed to remove infected ... [3] Oct 16, 2024 — The agents used are antimicrobials such as cefotaxime, gentamicin, ampicillin, and sulfamethoxazole. Empiric antimicrobial therapy must be ... [4] Drugs used to treat Peritonitis ; Generic name: ceftazidime systemic; Brand names: Fortaz, Tazicef; Drug class: third generation cephalosporins; For consumers: ... [7] by P Barretti · 2015 · Cited by 27 — The combination of a first generation cephalosporin with an aminoglycoside again became the recommended empirical treatment for PD-related peritonitis. Between ... [8] Nov 14, 2023 — Typically, you'll immediately start intravenous antibiotics or antifungal medications to treat the infection. You'll need more treatments if ...

Peritonitis, an inflammation of the peritoneum, can be caused by various factors, and its differential diagnosis involves a broad range of conditions. Here are some possible causes to consider:

• Infectious causes: These include primary infectious peritonitis (caused by an infection originating in the peritoneum itself) and secondary bacterial peritonitis (spreading from elsewhere in the body). [1][2]
• Gastrointestinal rupture or perforation: This can lead to peritonitis due to leakage of intestinal contents into the abdominal cavity. [8]
• Appendicitis (early stages): Inflammation of the appendix can mimic symptoms of peritonitis, especially in its early stages. [4][5]
• Abdominal aortic aneurysm: A ruptured or leaking abdominal aortic aneurysm can cause peritonitis due to leakage of blood and bacteria into the abdominal cavity. [4]
• Aortocaval fistula: An abnormal connection between the aorta and inferior vena cava can lead to peritonitis due to bacterial contamination. [4]
• Acute gastroenteritis: Inflammation of the stomach and intestines can cause symptoms similar to peritonitis, especially if it leads to bacterial overgrowth or perforation. [4][14]
• Aortoenteric fistula: An abnormal connection between the aorta and intestine can lead to peritonitis due to leakage of bacteria and blood into the abdominal cavity. [4]
• Cystitis (inflammation of the bladder) and pneumonia should be excluded in the differential diagnosis, as they can mimic symptoms of peritonitis. [9][14]
• Spontaneous bacterial peritonitis: This is a complication of liver disease, such as cirrhosis, where fluid buildup in the abdomen leads to bacterial contamination. [7][13]

It's essential to consider these potential causes when diagnosing peritonitis and to perform appropriate diagnostic evaluations to determine the underlying cause. A well-coordinated, interprofessional team approach can improve outcomes for patients presenting with an acute abdomen.