Peritonitis

Peritonitis is inflammation of the peritoneum, the lining of the abdominal cavity, most often caused by infection spreading from a ruptured organ such as the appendix or bowel. It is a surgical emergency requiring urgent treatment.

• Severe, widespread abdominal pain that worsens with movement or coughing
• A rigid, board-like abdomen on examination
• Fever
• Nausea and vomiting
• Signs of shock in advanced cases — rapid heart rate, low blood pressure

• Most commonly results from rupture of an inflamed organ, such as a ruptured appendix, perforated peptic ulcer, or perforated bowel, spilling infected contents into the abdominal cavity.
• Can also result from infection spreading from the female reproductive organs, or from complications of abdominal surgery.
• Any condition causing a hole or leak in the gastrointestinal tract can lead to peritonitis if untreated.

• Diagnosed clinically based on severe abdominal pain with a rigid abdomen and marked tenderness on examination.
• Blood tests typically show signs of infection and inflammation.
• Abdominal imaging, such as X-ray or ultrasound where available, can help identify the underlying cause, such as free air from a perforation.

Peritonitis is a surgical emergency requiring urgent hospital admission, intravenous fluids, and broad-spectrum intravenous antibiotics started as soon as the diagnosis is suspected.

Emergency surgery is usually needed to identify and repair the source of the infection, such as closing a perforation or removing a ruptured appendix, and to clean out infected material from the abdominal cavity.

Close monitoring for shock and organ dysfunction is essential, as peritonitis can progress rapidly to life-threatening sepsis.

Pain relief is given, but should not delay urgent surgical assessment.

• Seek prompt medical care for worsening or severe abdominal pain rather than waiting.
• Seek timely treatment for conditions that can lead to peritonitis if untreated, such as appendicitis or peptic ulcer disease.
• Follow medical advice closely after abdominal surgery, and report new or worsening abdominal pain promptly.