Peritonitis is the inflammation of the peritoneum, a thin membrane lining the interior of the abdomen and enveloping organs. Though the severity of peritonitis varies, doctors always approach it with urgency, given its potential to rapidly escalate – often within 24 to 48 hours – into an emergency that may be fatal.
When the infection causing peritonitis spreads to the bloodstream, it often leads to a systemic inflammatory response that significantly drops blood pressure (also known as septic shock or sepsis shock). The body releases chemicals into the bloodstream across large parts, slowing blood flow and potentially causing vital organ failure. In the most severe cases, septic shock is life-threatening.
In most cases, peritoneal inflammation stems from a bacterial infection, which can be primary or secondary.
Irrespective of the cause, immediate medical attention is crucial for individuals showing symptoms of peritonitis and shock, as the condition can be fatal if left untreated.
While symptoms of peritonitis may vary in each individual, common symptoms of the condition include:
Other symptoms that could also be present due to the presence of infection include:
In severe cases where individuals with peritonitis have progressed into septic shock, they may experience:
Patients who exhibit symptoms may experience sudden, extreme abdominal pain that is sensitive to touch or movement. Some may resort to laying flat or curling up due to intense pain and refuse to be touched in the abdomen area. Individuals with such symptoms should promptly seek medical attention for a thorough diagnosis and appropriate treatment, mitigating the risk of the condition deteriorating to a potentially life-threatening state.
It is important to recognise that individuals with peritonitis may either be asymptomatic or exhibit symptoms that resemble those of other health conditions. It is necessary to consult with a doctor for an accurate diagnosis. For individuals experiencing symptoms of both peritonitis and shock, it is necessary to seek immediate medical attention from a general surgery clinic or call 995 to contact a nearby hospital’s Accident and Emergency (A&E) Department
ACE Specialist Surgery and Endoscopy Clinic provides 24/7 emergency services for individuals with acute abdominal pain. Patients in need of urgent medical care for peritonitis and shock can contact ACE at any hour. Our team is dedicated to promptly diagnosing and treating such cases. We aim to schedule appointments or urgent surgeries with our skilled general surgeon as swiftly as possible to address the patient's needs.
Our general surgeon will kickstart the diagnostic process by asking about the individual’s medical history and current conditions and proceed to perform a physical examination to check for an unusually firm or tender abdomen.
Further tests to diagnose peritonitis include taking samples of the infected fluid from the abdomen for analysis in the lab. This process could help relieve the pressure in the abdomen for those with fluid accumulation in their bellies.
Additionally, doctors may do the following:
Considering the rapid development of peritonitis, often within a matter of days, individuals experiencing symptoms of the condition should regard it seriously and seek immediate medical attention from a doctor. This is because, if left untreated, patients may rapidly progress into septic shock, essentially a severe whole-body infection that can result in organ failure and death.
After a detailed diagnosis, our general surgeon will recommend suitable treatment options tailored to your unique condition.
In the majority of cases, patients with peritonitis require hospitalisation and administration of intravenous (IV) antibiotics to treat the infection. Emergency surgery is also frequently conducted to remove infected tissues, such as damaged parts of the intestines or abdominal organs, inflamed tissues, and bands of scar tissue. The surgery aims to address the underlying cause of the infection and prevent its further spread. Surgical intervention becomes particularly crucial when peritonitis is induced by a secondary infection resulting from a ruptured appendix, stomach, or other sources.
To sum up, peritonitis is a serious condition in which the lining of the abdomen becomes inflamed, usually due to bacterial infection. This inflammation can lead to symptoms like severe abdominal pain, fever, nausea, and vomiting. If not treated promptly, peritonitis can become life-threatening, as the infection may spread throughout the body, progressing into septic shock.
Those at risk of peritonitis include:
Individuals with compromised immune systems are more likely to develop peritonitis. Conditions like liver disease, kidney failure, heart failure, and cancer elevate the probability of experiencing ascites, a potential precursor to peritonitis. The combination of retained fluid and compromised immunity establishes conditions conducive to peritonitis, which may progress into septic shock.
Individuals engaged in home dialysis or utilising a feeding tube are more prone to bacterial infections in the peritoneum. The passage of the catheter through the peritoneum can introduce infection to the entire abdominal cavity.
To prevent primary peritonitis, individuals at risk, such as those undergoing dialysis or using a feeding tube, need to exercise caution. Maintaining meticulous hand and fingernail cleanliness is crucial for people on peritoneal dialysis to prevent contamination of the dialysis catheter. Daily cleaning of the skin around the catheter is recommended, following the instructions provided by the dialysis team.
Individuals should focus on reducing the likelihood of underlying causes to prevent secondary peritonitis. For example, minimising the risk factors for conditions like alcoholic cirrhosis or stomach ulcers can help prevent the development of peritonitis.
Similarly, individuals who have experienced traumatic abdominal injuries or have been diagnosed with appendicitis or similar conditions should promptly seek professional medical treatment. This proactive approach reduces the infection risk that could lead to peritonitis.
Peritonitis may recur after treatment, especially in dialysis patients. Individuals should seek medical advice from their doctors to reduce or prevent the likelihood of peritonitis recurrence.
Recovery time for patients can vary depending on the severity of their conditions. Patients who have been diagnosed early and received prompt treatment may experience recovery within days or a few weeks. However, individuals with severe peritonitis, those who require surgery, or those who encounter additional complications may need a more extended recovery period.
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