Peritonitis

Peritonitis is a type of fungal infection of the abdominal wall caused by swelling of peritoneum (a soft membrane lining of the stomach). It would cause bloated feeling and abdominal cramps. Peritonitis needs to be treated immediately failing which it can cause complications like organ failure and even death. To prevent any serious complications, it should be treated promptly. It can be treated and controlled by antibiotics and in severe cases it has to be surgically operated.

Symptoms :

Some of the common signs of peritonitis are moderate to severe abdominal pain, tenderness, nausea, vomiting, fever, bloating sensation, diarrhea or inability to pass stool and extreme tiredness. For people who are doing peritoneal dialysis it can cause cloudy fluid and white strands of fibrin during dialysis. If you have severe abdominal pain with problems in passing urine or stool, then you need to seek immediate medical advice.

Causes :

  • Any sudden perforation (rupture) of the abdominal wall can cause peritonitis. The soft membrane of the abdomen peritoneum can get broken due to several factors.
  • Certain type of medical procedures like peritoneal dialysis can cause perforation in peritoneum. Using poor hygienic instruments during dialysis can cause infection of peritoneum leading to peritonitis.
  • It can occur during the process of gastrointestinal surgery.
  • Bacteria can easily enter into the peritoneum during the above procedures.
  • Pancreatitis can also lead to peritonitis if the bacteria could migrate outside pancreas.
  • Any infection in the digestive tract can cause rupture of the abdominal wall causing peritonitis. Any sudden injury to the stomach can cause this condition.
  • Certain types of liver disease can cause peritonitis.
  • Primary peritonitis is caused by liver cirrhosis and kidney failure.
  • Secondary peritonitis can be caused due to pelvic inflammatory disease, Crohn’s disease, diverticulitis, any surgical procedure and trauma.

Risk Factors :

Peritonitis infection can occur to people who undergo peritoneal dialysis. Hence it is necessary to use sterile surgical instruments during dialysis. If left untreated, it can cause sepsis (internal infection) which can lead to organ failure.

Diagnosis :

Your doctor will complete the physical exam and look for the above symptoms. He will collect your medical history and check for cloudy fluid during dialysis in case you are a patient of dialysis therapy. He may order for series of tests including blood profile, peritoneal fluid analysis, and imaging tests like X-ray or CT scan to check the condition of your abdomen.

Treatment :

  • Depending on the condition of the patient, he/she may be hospitalized for treating peritonitis infection.
  • The doctor will start Intravenous fluids and give suitable antibiotics to prevent the bacterial infection.
  • If the condition is critical surgery is done to remove the infected or dead tissue from the abdomen.
  • For people who undergo peritoneal dialysis extreme care should be taken to prevent any infection.
  • Until the infection heals completely, the dialysis therapy is given through alternative methods.

Prevention :

Take enough steps while doing peritoneal dialysis to maintain proper hygiene. The nurse and surgeon should thoroughly wash their hands before using any catheters. The skin area around the catheter should be cleaned with antiseptic solution. The entire team should use proper sterile instruments during the procedure. It is necessary to take antibiotics prescribed by your doctor in case you have spontaneous peritonitis before due to underlying medical conditions.

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