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Peritonitis

Inflammation of the peritoneum caused by bacterial or chemical contamination, requiring urgent surgical intervention.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Peritonitis?

Peritonitis is a diffuse or localized inflammation of the visceral and parietal peritoneum caused by contact with contaminating substances such as bacteria, feces, bile, gastric contents, or blood. It is classified as primary peritonitis (hematogenous spread, particularly in cirrhosis and nephrotic syndrome patients) and secondary peritonitis (intra-abdominal source such as perforation, appendicitis, or diverticulitis).

Secondary peritonitis develops as a complication of pathologies such as perforated appendicitis, gastroduodenal perforation, colonic perforation, and gallbladder perforation. Untreated peritonitis progresses to sepsis and multiple organ failure, leading to death.

Tertiary peritonitis is a persistent diffuse infection following adequately treated secondary peritonitis, often related to immune deficiency or fungal/resistant gram-negative organisms after intensive antibiotic use.

Symptoms

Board-like rigid abdomen and diffuse tenderness (pain worsened by palpation)
High fever and chills
Tachycardia and hypotension (septic shock)
Nausea, vomiting, absent bowel sounds (ileus)
Abdominal distension
Abdomen does not move with respiration

Risk Factors

Perforated appendicitis, ulcer, or diverticulitis
Abdominal surgery complications (anastomotic leak)
Liver cirrhosis and ascites (for primary peritonitis)
Peritoneal dialysis catheter infection
Immunosuppressive therapy and diabetes mellitus
Delayed surgical treatment

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Whole abdominal tenderness and board-like rigidity require emergency department admission
  • Abdominal pain with fever, tachycardia, and hypotension
  • Increasing abdominal pain after abdominal surgery
  • Fever and abdominal pain in a cirrhotic patient (suspicion of SBP)
  • Cloudy dialysis fluid in a peritoneal dialysis patient

Treatment Methods

01
Emergency intensive care: large IV access, aggressive fluid resuscitation, vasopressors
02
Broad-spectrum intravenous antibiotics: gram-negative, gram-positive, and anaerobic coverage
03
Source control: surgical exploration, perforation repair, or resection
04
Intra-abdominal lavage: peritoneal washing with warm saline
05
Open abdomen management (damage control): in heavily contaminated or severely septic cases
06
Primary peritonitis (SBP): 5-7 days of cefotaxime or amoxicillin-clavulanate; surgery is not required

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.