peritonitis

Inflammation of peritoneum (a silk-like membrane lining the inner abdominal wall and covering abdominal organs). It is usually due to a bacterial or fungal infection.
Without treatment, death may occur within a few days.

Types:
• Spontaneous bacterial peritonitis: Develops as a complication of liver disease (e.g. cirrhosis) or of kidney disease.
• Secondary peritonitis: Results from rupture or perforation in abdomen, or as a complication of other medical conditions (e.g. appendicitis, diverticulitis).
• Tuberculosis peritonitis: Caused by Mycobacterium tuberculosis (TB).
• Chemical peritonitis (sterile peritonitis): Caused by leakage of sterile fluids that are irritants to the peritoneum (e.g. bile, blood, or barium as a contrast agent).
• Peritoneal abscess: Caused by an infected fluid collection.

Symptoms:
• severe pain of abdomen
• swelling of abdomen
• tenderness of abdomen
• weight loss
• fever

Causes:
• perforation of the intestinal tract, stomach ulcer
• pancreatitis, (ruptured) appendicitis, pelvic inflammatory disease
• cirrhosis

Risk factors:
• ascites
• peritoneal dialysis

Diagnosis:
• examination
• blood tests
• imaging

Treatment:
• antibiotics: Beta-lactams (penicillins), carbapenems (beta-lactamase-resistant beta-lactams), cephalosporins (semi-synthetic beta-lactams), and quinolones (ciprofloxacin).
• intravenous fluids
• pain medication
• surgery
(The following procedures may be also needed.)
• nasogastric tube
• blood transfusion

Complications:
• shock
• acute respiratory distress syndrome