Peritonitis

Peritonitis
SynonymsSurgical abdomen, acute abdomen[1]
Tuberculous peritonitis (6544825621).jpg
Peritonitis from tuberculosis
Pronunciation
SpecialtyEmergency medicine, general surgery
SymptomsSevere pain, swelling of the abdomen, fever[2][3]
ComplicationsShock, acute respiratory distress syndrome[4][5]
Usual onsetSudden[1]
TypesPrimary, secondary[1]
CausesPerforation of the intestinal tract, pancreatitis, pelvic inflammatory disease, cirrhosis, ruptured appendix[3]
Risk factorsAscites, peritoneal dialysis[4]
Diagnostic methodExamination, blood tests, medical imaging[6]
TreatmentAntibiotics, intravenous fluids, pain medication, surgery[3][4]
FrequencyRelatively common[1]

Peritonitis is inflammation of the peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs.[2] Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss.[2][3] One part or the entire abdomen may be tender.[1] Complications may include shock and acute respiratory distress syndrome.[4][5]

Causes include perforation of the intestinal tract, pancreatitis, pelvic inflammatory disease, stomach ulcer, cirrhosis, or a ruptured appendix.[3] Risk factors include ascites and peritoneal dialysis.[4] Diagnosis is generally based on examination, blood tests, and medical imaging.[6]

Treatment often includes antibiotics, intravenous fluids, pain medication, and surgery.[3][4] Other measures may include a nasogastric tube or blood transfusion.[4] Without treatment death may occur within a few days.[4] Approximately 7.5% of people have appendicitis at some point in time.[1] About 20% of people with cirrhosis who are hospitalized have peritonitis.[1]

Signs and symptoms

Abdominal pain

The main manifestations of peritonitis are acute abdominal pain, abdominal tenderness and abdominal guarding, which are exacerbated by moving the peritoneum, e.g., coughing (forced cough may be used as a test), flexing one's hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits less pain than releasing the hand abruptly, which will aggravate the pain, as the peritoneum snaps back into place). Rigidity (involuntary contraction of the abdominal muscles) is the most specific exam finding for diagnosing peritonitis (+ likelihood ratio: 3.9). The presence of these signs in a patient is sometimes referred to as peritonism.[7] The localization of these manifestations depends on whether peritonitis is localized (e.g., appendicitis or diverticulitis before perforation), or generalized to the whole abdomen. In either case, pain typically starts as a generalized abdominal pain (with involvement of poorly localizing innervation of the visceral peritoneal layer), and may become localized later (with the involvement of the somatically innervated parietal peritoneal layer). Peritonitis is an example of an acute abdomen.

Other symptoms

Complications

Other Languages
azərbaycanca: Peritonit
беларуская: Перытаніт
български: Перитонит
bosanski: Peritonitis
català: Peritonitis
čeština: Peritonitida
Deutsch: Peritonitis
eesti: Peritoniit
Ελληνικά: Περιτονίτιδα
español: Peritonitis
euskara: Peritonitis
français: Péritonite
한국어: 복막염
hrvatski: Peritonitis
Bahasa Indonesia: Peritonitis
íslenska: Lífhimnubólga
italiano: Peritonite
עברית: דלקת הצפק
Кыргызча: Перитонит
日本語: 腹膜炎
português: Peritonite
română: Peritonită
русский: Перитонит
саха тыла: Перитонит
Simple English: Peritonitis
српски / srpski: Peritonitis
srpskohrvatski / српскохрватски: Peritonitis
Tagalog: Peritonitis
Türkçe: Peritonit
українська: Перитоніт
中文: 腹膜炎