Peritonitis is a serious medical emergency that occurs when the peritoneum,the thin membrane lining the inside of the abdomen and covering most abdominal organs, becomes inflamed, usually due to a bacterial or fungal infection. Without prompt treatment, peritonitis can rapidly spread throughout the body, leading to severe complications such as sepsis, organ failure, and even death.
Peritonitis often develops as a complication of another medical condition, such as a ruptured appendix, perforated stomach ulcer, intestinal perforation, abdominal injury, or complications of peritoneal dialysis. Early recognition of the symptoms and immediate medical attention are essential for successful treatment.
In this article, you will learn about the causes of peritonitis, its symptoms, risk factors, diagnosis, treatment options, possible complications, and ways to reduce your risk.
Medically Reviewed by
Scientist Shuaibu Omoko
Founder, Omokos Diagnostics
This article has been reviewed for scientific accuracy and educational purposes. It is intended for public health education and should not replace consultation with a qualified healthcare professional.
What Is Peritonitis?
The peritoneum is a thin protective membrane that lines the abdominal cavity and supports many of the abdominal organs, including the stomach, liver, intestines, and spleen.
Peritonitis occurs when this membrane becomes inflamed, most commonly because bacteria or fungi enter the abdominal cavity through a hole or tear in an abdominal organ. Because the infection can spread quickly, peritonitis requires immediate medical treatment.
Types of Peritonitis
Peritonitis is generally classified into three main types:
Primary Peritonitis
Also called spontaneous bacterial peritonitis (SBP), this type occurs without a hole in the intestine or another abdominal organ. It is most commonly seen in people with advanced liver disease and ascites (fluid accumulation in the abdomen).
Secondary Peritonitis
This is the most common type and occurs when bacteria enter the abdominal cavity following a perforation or rupture of an abdominal organ.
Common causes include:
- Ruptured appendix
- Perforated stomach or duodenal ulcer
- Diverticulitis with bowel perforation
- Perforated intestine
- Traumatic abdominal injury
- Leakage following abdominal surgery
Tertiary Peritonitis
This refers to persistent or recurrent infection that continues despite appropriate treatment of secondary peritonitis. It usually occurs in critically ill patients.
Causes of Peritonitis
Several conditions can lead to peritonitis, including:
- Appendicitis with rupture
- Perforated peptic ulcer
- Diverticulitis
- Perforated bowel
- Gallbladder infection with perforation
- Pancreatitis (in some cases)
- Abdominal trauma
- Complications after abdominal surgery
- Peritoneal dialysis-related infection
- Tuberculosis (rare cause in some regions)
Risk Factors
You may have a higher risk of developing peritonitis if you have:
- Liver cirrhosis with ascites
- Kidney failure requiring peritoneal dialysis
- Recent abdominal surgery
- Appendicitis
- Peptic ulcer disease
- Diverticular disease
- Inflammatory bowel disease
- Abdominal injuries
Symptoms of Peritonitis
Symptoms often develop suddenly and worsen rapidly.
Common symptoms include:
- Severe abdominal pain
- Abdominal tenderness
- Swollen or bloated abdomen
- Fever
- Chills
- Nausea
- Vomiting
- Loss of appetite
- Constipation or inability to pass gas
- Extreme weakness
- Rapid heartbeat
As the condition progresses, patients may become confused, dehydrated, or develop signs of shock.
When Should You Seek Emergency Medical Care?
Seek immediate medical attention if you experience:
- Sudden severe abdominal pain
- A rigid or swollen abdomen
- Persistent vomiting
- Fever with severe abdominal pain
- Difficulty passing stool or gas
- Fainting or confusion
- Symptoms after abdominal surgery
- Severe abdominal pain in someone receiving peritoneal dialysis
Peritonitis is a medical emergency and should never be treated at home.
Complications of Peritonitis
Without prompt treatment, peritonitis may lead to:
- Sepsis
- Septic shock
- Multiple organ failure
- Abdominal abscess
- Intestinal obstruction
- Kidney failure
- Death
Early diagnosis and treatment greatly improve the chances of recovery.
How Is Peritonitis Diagnosed?
Doctors diagnose peritonitis using a combination of clinical examination, laboratory investigations, and imaging studies.
Common investigations include:
- Medical history and physical examination
- Full Blood Count (FBC)
- C-reactive Protein (CRP)
- Blood culture
- Electrolyte and kidney function tests
- Liver function tests
- Abdominal ultrasound
- CT scan of the abdomen
- Analysis of peritoneal fluid (when indicated)
These tests help identify the source and severity of the infection.
Can Ultrasound Detect Peritonitis?
Ultrasound may help identify conditions associated with peritonitis, including:
- Free fluid in the abdomen
- A ruptured appendix
- Abdominal abscess
- Inflamed abdominal organs
- Gallbladder disease
However, ultrasound alone cannot confirm all cases of peritonitis. A CT scan is often recommended when more detailed imaging is needed.
Treatment for Peritonitis
Treatment depends on the underlying cause but usually includes emergency hospital care.
Antibiotics
Broad-spectrum intravenous antibiotics are started as soon as possible to control the infection.
Surgery
Emergency surgery may be necessary to:
- Remove a ruptured appendix
- Repair a perforated intestine
- Treat a perforated ulcer
- Drain an abscess
- Remove infected tissue
Supportive Care
Patients may also require:
- Intravenous fluids
- Pain management
- Oxygen therapy
- Nutritional support
- Intensive care monitoring in severe cases
Recovery
Recovery depends on:
- The cause of peritonitis
- How quickly treatment begins
- The patient’s age
- Overall health
- Presence of complications
Early treatment generally results in better outcomes.
Can Peritonitis Be Prevented?
Although not all cases can be prevented, you can reduce your risk by:
- Seeking prompt treatment for appendicitis
- Treating stomach ulcers appropriately
- Managing diverticular disease
- Following sterile procedures during peritoneal dialysis
- Seeking medical care for severe abdominal pain without delay
Frequently Asked Questions
Is peritonitis life-threatening?
Yes. Without prompt treatment, peritonitis can lead to sepsis, organ failure, and death.
Can antibiotics alone cure peritonitis?
Some cases may respond to antibiotics alone, particularly spontaneous bacterial peritonitis. However, many patients with secondary peritonitis require surgery to remove the source of infection.
Is peritonitis contagious?
No. Peritonitis cannot be spread from one person to another.
How long is hospital treatment?
Hospital stay depends on the severity of the infection and the patient’s response to treatment. Some patients recover within several days, while others require longer hospitalization.
Diagnostic Services at Omokos Diagnostics
At Omokos Diagnostics, we provide laboratory and ultrasound investigations that assist healthcare providers in evaluating patients with abdominal pain and suspected abdominal infections. Our services include Full Blood Count (FBC), C-reactive Protein (CRP), Blood Culture, Urinalysis, Kidney Function Tests, Liver Function Tests, Abdominal Ultrasound, Pelvic Ultrasound, and other diagnostic investigations performed using quality-controlled laboratory procedures.
Patients suspected of having peritonitis should seek immediate hospital care, as emergency treatment is often required.
Conclusion
Peritonitis is a serious and potentially life-threatening infection of the lining of the abdominal cavity. It commonly develops as a complication of conditions such as a ruptured appendix, perforated ulcer, bowel perforation, or abdominal injury.
Recognizing symptoms early and seeking immediate medical attention can prevent serious complications and improve recovery. Prompt diagnosis using laboratory tests and imaging studies, followed by appropriate medical or surgical treatment, is essential for successful management.
Medical Disclaimer
This article is intended for educational and informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Peritonitis is a medical emergency. If you experience severe abdominal pain, fever, abdominal swelling, persistent vomiting, or signs of shock, seek immediate medical attention or visit the nearest emergency department. Never delay treatment because of information you have read online.
References
- World Society of Emergency Surgery (WSES). Guidelines for the Management of Intra-abdominal Infections.
- World Health Organization (WHO). Patient Safety and Emergency Surgical Care.
- National Institute for Health and Care Excellence (NICE). Acute Abdominal Pain Guidelines.
- Merck Manual Professional Edition. Peritonitis.
- Mayo Clinic. Peritonitis: Symptoms and Causes.
- Cleveland Clinic. Peritonitis: Causes, Symptoms, Diagnosis, and Treatment.
- American College of Surgeons (ACS). Abdominal Emergencies.
- StatPearls Publishing. Peritonitis. Updated regularly through the NCBI Bookshelf.
