Peritonitis Overview

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Peritonitis is the inflammation of the peritoneum, caused by a bacterial or fungal infection. The peritoneum is the thin, silky membrane that lines the inside of your abdomen and covers the organs in your abdominal cavity. Peritonitis is classified as either primary (spontaneous) or secondary, based on the origin of the infection.

Primary Peritonitis

Primary peritonitis is less common and affects the peritoneum directly through an infection in your blood or lymph nodes. It is usually caused by liver or kidney failure. People on peritoneal dialysis, those with cirrhosis, and Hepatitis B or C are at higher risk for this type of inflammation.

Secondary Peritonitis

Secondary peritonitis occurs when an infection spreads from another organ, most commonly through a tear in your gastrointestinal tract. The gastrointestinal tract can become perforated as a result of a ruptured appendix, an injury to an internal abdominal organ, or a stomach ulcer. Infection can also spread to the peritoneum from the pancreas (pancreatitis), gallbladder, or diverticulum (diverticulitis). Sufferers of these diseases are at increased risk for peritonitis, as are people who have previously had peritonitis.


Regardless of the cause, the symptoms of both types are the same:

  • abdominal pain, tenderness, or bloating
  • nausea or vomiting
  • fatigue
  • fever and chills
  • loss of appetite
  • diarrhea or constipation
  • low urine output
  • fluid in the abdomen

Tests & Treatments

If your doctor suspects you have peritonitis, he or she will first perform a physical examination of the abdomen, checking for distention and tenderness. Your doctor may then order any number of a series of tests to confirm a diagnosis. Blood or fluid from your peritoneum may be drawn and examined for the presence of bacteria. Imaging tests may also be used to check for perforations in your gastrointestinal tract. If the tests conclude you have peritonitis, your doctor will proceed based on the severity of your case.

You will probably be given intravenous antibiotics to fight the infection and stop it from spreading to the rest of your body. Surgery may be necessary to remove infected tissue, repair damaged organs, and flush the abdominal cavity of bacteria. Your recovery depends on the stage of your peritonitis, your general health and strength, and the presence of underlying conditions. Because peritonitis can be serious and potentially fatal, see a doctor at the first signs of symptoms. 

Written by: the Healthline Editorial Team
Edited by:
Medically Reviewed by: Jennifer Monti, MD, MPH
Published: Aug 25, 2010
Last Updated: Jan 22, 2014
Published By: Healthline Networks, Inc.
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