Peritonitis - secondary
Secondary peritonitis
The peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs. Peritonitis is present when this tissue becomes inflamed or infected. Secondary peritonitis is when another condition is the cause.
Causes
Secondary peritonitis has several major causes.
- Bacteria may enter the peritoneum through a hole (perforation) in an of the organ 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.
-
Bile
or chemicals released by the pancreas may leak into the abdominal cavity. This may be caused by
sudden swelling and inflammation of the pancreas
.
Bile
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...
Sudden swelling and inflammation of the...
Acute pancreatitis is sudden swelling and inflammation of the pancreas.
- 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. This problem nearly always develops in an infant who is ill or born early.
Necrotizing enterocolitis
Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
Symptoms
Symptoms include:
-
Swollen abdomen
when your belly area is bigger than usual
Swollen abdomen
A swollen abdomen is when your belly area is bigger than usual.
-
Abdominal pain
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
- Decreased appetite
-
Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
-
Low urine output
Low urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 ml of urine in 24 hours (a little over 2 cups)....
- Nausea
-
Thirst
Thirst
Excessive thirst is an abnormal feeling of always needing to drink fluids.
- Vomiting
Note: There may be signs of shock .
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
Exams and Tests
During a physical exam, the health care provider may notice abnormal vital signs with fever, rapid heart rate and breathing, and low blood pressure.
Vital signs
Vital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...
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.
Tests may include:
-
Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
- Blood chemistry, including pancreatic enzymes
- Complete blood count
- Liver and kidney function tests
- X-rays or CT scan
-
Peritoneal fluid culture
Peritoneal fluid culture
Peritoneal fluid culture is a laboratory test performed on a sample of peritoneal fluid to detect bacteria or fungi that cause infection (peritonitis...
- Urinalysis
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Treatment
Often, surgery is needed to remove or treat sources of infection. These may be an infected bowel, an inflamed appendix, or an abscess .
Abscess
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.
General treatment includes:
- Antibiotics
- Fluids through a vein (IV)
- Pain medicines
- Tube through the nose into the stomach or intestine (nasogastric or NG tube)
Outlook (Prognosis)
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
Possible Complications
Complications may include:
- Abscess
- Gangrene (dead) bowel
-
Intraperitoneal
adhesions
(a potential cause of future bowel blockage)
Adhesions
Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
-
Septic shock
Septic shock
Septic shock is a serious condition that occurs when a body-wide infection leads to dangerously low blood pressure.
When to Contact a Medical Professional
Call your provider if you have symptoms of peritonitis . This is a serious condition. It needs emergency treatment in most cases.
Peritonitis
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...
References
Turnage RH, 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 . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 45.
Wyers SG, Matthews JB. 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 . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 38.
Review Date: 5/11/2016
Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.