Inflammation in the Abdomen: A Comprehensive Guide to Peritonitis

Peritonitis

Symptoms

• Severe Abdominal Pain: Often sudden and worsens with movement, coughing, or touch.
• Abdominal Tenderness and Rigidity: Abdomen feels hard and is very tender to touch.
• Bloating and Distension: Visible swelling of the abdomen due to fluid or gas buildup.
• Fever and Chills: Signs of the body fighting infection or inflammation.
• Nausea and Vomiting: Often accompanied by loss of appetite.
• Altered Bowel Movements: Diarrhea or constipation can occur.
• Fatigue and Malaise: General feeling of unwellness, weakness, and fatigue.
• Thirst and Reduced Urine Output: Signs of dehydration from vomiting or fever.

Causes

• Primary Peritonitis (Spontaneous Bacterial Peritonitis): Occurs without a clear source of infection, often in patients with pre-existing conditions like liver cirrhosis or nephrotic syndrome.
• Secondary Peritonitis: More common, caused by perforation or rupture in the abdomen, leading to contamination. Common causes include:
  • Appendicitis
  • Diverticulitis
  • Perforated Peptic Ulcer
  • Trauma (surgery, accidents, stab wounds)
  • Pancreatitis
  • Peritoneal Dialysis

Diagnosis

• Medical History and Physical Examination: Doctor asks about symptoms, duration, pre-existing conditions, and recent surgeries. Exam checks for tenderness, rigidity, and guarding.
• Laboratory Tests:
  • Blood Tests: Look for elevated white blood cell count and inflammatory markers.
  • Blood Cultures: Identify the causative organisms (especially in primary peritonitis).
• Imaging Studies:
  • X-rays: Detect free air under the diaphragm (perforated GI tract).
  • Ultrasound: Identify fluid collections, abscesses, or organ-related issues.
  • CT Scans: Provide detailed abdominal cavity images to find the source of infection or perforation.
• Peritoneal Fluid Analysis:
  • Paracentesis: A sample of peritoneal fluid is extracted and analyzed for white blood cells, bacteria, and chemical composition. High white blood cells or bacteria confirm peritonitis.

Treatment

• Antibiotic Therapy:
  • Empiric Antibiotics: Broad-spectrum antibiotics are given immediately to cover a wide range of bacteria.
  • Targeted Antibiotics: Once specific bacteria are identified, antibiotics may be adjusted.
• Surgical Intervention:
  • Emergency Surgery: Often needed for secondary peritonitis to address the underlying cause (repairing ulcers, removing appendix, cleaning the abdomen).
  • Drainage of Abscesses: May be drained surgically or percutaneously (through the skin with imaging guidance).
• Supportive Care:
  • Intravenous Fluids: Maintain hydration, correct electrolyte imbalances, and support blood pressure.
  • Pain Management: Provide analgesics to manage severe pain.
  • Nutritional Support: Patients who cannot eat may require total parenteral nutrition (TPN).
• Monitoring and Follow-Up: Regularly monitor vital signs, blood tests, and imaging studies to assess treatment effectiveness and detect complications.

Disclaimer:

The information provided in this article is for educational purposes only and should not be considered medical advice. If you have any health concerns or are experiencing symptoms, it is important to consult with a healthcare professional, such as a doctor or clinic, for proper diagnosis and treatment. Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read in this article.

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