Peritonitis - Symptoms, Diagnosis, Treatment

Peritonitis is not very hard to diagnose because of its typical presenting symptoms. 

Initial symptoms usually include:

• Loss of appetite
• Nausea
• Slight abdominal pain that gradually worsens

Subsequent symptoms include:

• Vomiting
• Fever accompanied with chills
• Shortness of breath
• Problems with passing gas and stool
• Low urine output
• Abdominal tenderness
• Abdominal bloating
• Excessive fatigue
• Excessive thirst
• Elevated heart rate

In case of peritoneal dialysis, the following symptoms may also appear:

• Fibrin (seen as white strands) in the dialysis fluid
• Unclear dialysis fluid

How is Peritonitis Diagnosed?

Diagnosing peritonitis early is very important, since the complications that may develop can prove to be life-threatening.

• Medical History – questions about signs and symptoms, allergies, medications you may be taking, prior abdominal problems or surgeries.
• Physical Examination – check for abdominal tenderness or stiffness, patients usually curl up or refuse to be examined in that area.
• Blood tests – check for elevated white blood count, blood culture to check for bacterial infection.
• Analysis of Peritoneal Fluid (Paracentesis) – sample of peritoneal fluid drawn via a needle for examination of white blood count or presence of bacteria.
• Analysis of Peritoneal Dialysis Fluid – unclear, cloudy fluid is indicative of infection.
• Imaging Tests – X-rays (check for perforations), ultrasound, CT Scan.

How is Peritonitis Treated?

The following treatment options are available to treat peritonitis once admitted to the hospital:

• Administration of intravenous (IV) antibiotics and antifungal medications.
• Secondary supportive treatments in case of organ failure due to sepsis from the infection. These may include IV fluids, drugs, maintenance of blood pressure and nutritional supplements.
• For the treatment of peritonitis due to peritoneal dialysis, medications are injected directly into the peritoneal tissue. Some other form of dialysis, such as haemodialysis, is administered as an alternative.
• Often emergency surgery may be required, especially if the underlying cause is appendicitis, diverticulitis or stomach ulcer. Infected damaged tissue or any abscess will be surgically removed.

How Can Peritonitis be Prevented?

However, the following measures may help lower the risk of such an infection:

• Report any abdominal pain or discomfort that you may develop.
• Maintain proper sterile conditions.
• Maintaining hygiene. Before handling the catheter, wash your hands thoroughly, particularly the areas between the fingers and underneath the fingernails.
• Wearing a mask to cover the mouth.
• In case of an infection, daily apply an antibiotic cream to the site where the catheter has been inserted.
• Report any possible contamination of the dialysis fluid or the catheter site. A course of antibiotics may help prevent an infection from developing.

See Also: Baby Colic (Abdominal Pain in Infants) - Symptoms and Treatment

What are the Complications of Peritonitis?

This may lead to:

• Bacteremia (infection of bloodstream)
• Sepsis (infection within the body). If this condition progresses, it can be fatal and may cause shock or organ failure.