DEFINITIÓN

Acute and sudden inflammation of the peritoneum, the membrane that limits the abdominal wall and covers the abdominal organs.

CAUSES, INCIDENCE AND RISK FACTORS

Acute peritonitis can be spontaneous, a rare disease in which the peritoneum gets infected from the blood; depending on many causes, it usually complicates some liver cirrhoses, or much more frequently:

• Perforation of an organ covered by the peritoneum.
• Abdominal traumas or blood from any origin on the peritoneum.
• Intestinal occlusion with strangulation of the digestive tract.
• Pancreatitis.
• Vascular catastrophes of the abdomen (Mesenteric Thrombosis).
• Inflammatory disease of the pelvis, in turn dependent on many cause (intrauterine devices, ectopic pregnancy, gonorrhea and other sexually transmitted diseases, septic abortions).

SYMPTOMS

The typical peritonitis symptoms are those of acute abdomen, that is, those of a maximum abdominal pain scenario, with a sudden start. It is accompanied by nausea, vomiting, high fever and a considerable general malaise.

DIAGNÓSIS

Physical Exam. Pain and resistance when touching the abdomen (releasing hurts more than pressing). High sensitivity to noise. Fever. Severity.

Blood analysis. White cells are found in blood in an increased number.

Simple Radiography of the abdomen: When there’s a perforation, gas is visible just below the diaphragm.

Most cases of peritonitis, however, are diagnosed by laparotomy, that is, operating the abdomen when there’s a strong suspicion of peritonitis.

TREATMENT

In general, peritonitis is a surgical emergency and needs urgent surgery that includes identification and early treatment of the cause.

PROGNOSIS Y COMPLICATIONS

Without treatment, peritonitis can get complicated very quickly with dehydration and the so called multiorgan failure, which causes the patient’s death in a few days.

With surgery and the right support measures, it usually evolves towards healing.