Peritoneum is a thin membrane that lines the inside the belly (abdomen – the area between the chest and the pelvis) and wraps around various organs inside.
Peritonitis is the inflammation of the peritoneum.
This usually happens when something leaks or breaks inside the abdominal cavity. Fungal or bacterial infections are the most common cause of peritonitis, and it can be very dangerous, as if left untreated, It can lead to a serious or deadly infection (sepsis) that can spread through the body and causing shock, organs failure or even death.
Common Symptoms of peritonitis can include:
- The patient can’t sit still or find a comfortable position.
- Belly pain or tenderness and very sensitive to touch.
- Bloating or a feeling of fullness in the abdomen.
- Ascites – swollen belly – a condition of excess fluid from leaking veins that accumulates in the peritoneum. Major causes for ascites may include liver disease, kidney failure, heart failure and cancer.
- Upset stomach and vomiting.
- Loss of appetite.
- Diarrhoea
- Reduced urine output.
- Great thirst – dehydration.
- Paralytic ileus – when bowels are temporarily paralyzed.
- Unable to pass stool or gas
- Feeling tired or malaise.
- Confusion – cognitive impairment.
- Fast heart rate.
- Shortness of breath.
- Swollen legs and feet (oedema).
- Easy bruising and bleeding
- Cloudy dialysis fluid with an unusual colour and smell
Here are possible causes or risk factors of peritonitis:
- Spontaneous bacterial peritonitis. It can happen due to the liver disease, such as cirrhosis, or kidney disease due to renal failure called peritoneal dialysis – patients who get this treatment.
- Secondary peritonitis the most common one – which normally happens due to a rupture or a hole, inside an organ in the abdomen e.g., stomach and colon or a penetrating wound of the stomach wall, e.g. drains, dialysis tubes – catheters, feeding tubes – medical or surgical instruments etc.
- After the appendix rupture (appendicitis).
- A perforated stomach ulcer (peptic ulcer disease).
- A punctured intestinal ulcer from diverticulitis (Infection of small, bulging pouches in the digestive tract) or IBD – inflammatory bowel disease and Crohn’s disease.
- A serious injury to your abdomen.
- Chemical reaction to different body fluids, e.g., bile can leak from the gallbladder if severe inflammation (cholecystitis) causes a perforation in the tissues.
- Pancreatitis when pancreatic enzymes leak from your pancreas due to its severe inflammation, causing a perforation in the tissues.
- Gastric acid can leak from the stomach if an ulcer wears a hole all the way through.
- A tumor or cyst that ruptures in your abdomen can cause chemical peritonitis too.
- A ruptured tubo-ovarian abscess from pelvic inflammatory disease.
- A ruptured ectopic pregnancy.
- Abdominal or digestive surgery.
- A complication of endoscopy or colonoscopy – an exam to check inside the digestive tract, rectum and colon with a camera.
Prevention
- Peritonitis that’s mainly linked with peritoneal dialysis is caused by germs around the catheter.
- Wash your hands before you touch the catheter.
- Scrub under your fingernails and between your fingers.
- Clean the skin around the catheter with an antiseptic every day.
- Store your supplies in a clean place.
- Wear a surgical mask during your dialysis fluid exchanges.
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