Peritoniit

Peritoniit, also known as peritonitis, is inflammation of the peritoneum, the thin membrane that lines the abdominal cavity and covers abdominal organs. It is typically caused by infection, usually bacteria, but it can also result from chemical irritation after leakage of digestive contents into the abdomen. It is a medical emergency requiring urgent evaluation and treatment.

Causes are usually divided into primary, secondary, and tertiary forms. Primary peritonitis occurs without an evident intra-abdominal source, most often in people with ascites due to liver disease or kidney failure. Secondary peritonitis results from a perforated viscus or other intra-abdominal pathology, such as appendicitis, diverticulitis, peptic ulcer perforation, trauma, or postoperative contamination. Tertiary peritonitis refers to persistent or recurrent infection after initial treatment, sometimes in severely ill patients or those with weakened immune systems.

Symptoms commonly include sudden, severe abdominal pain, tenderness with guarding, abdominal rigidness, fever, nausea, vomiting, and distension. Patients may have a rapid heart rate and signs of sepsis; the elderly or immunocompromised can present with less typical symptoms.

Diagnosis relies on clinical suspicion supported by tests. Blood tests often show leukocytosis and elevated inflammatory markers. Imaging, particularly computed tomography (CT) or ultrasound, helps identify the source. Diagnostic paracentesis is essential when ascites is present to analyze the peritoneal fluid.

Treatment requires rapid resuscitation and broad-spectrum antibiotics covering Gram-negative and anaerobic bacteria, with source control through surgery or drainage when indicated. Prognosis depends on the cause, promptness of treatment, and the patient’s overall health.