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    Peritonitis - spontaneous

    Spontaneous bacterial peritonitis (SBP)

    Peritonitis is inflammation of the peritoneum, the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs.

    Causes

    Spontaneous peritonitis is usually caused by infection of ascites, a collection of fluid in the peritoneal cavity. This usually occurs from severe liver or kidney disease.

    Risk factors for liver disease include excessive alcohol use and other diseases that lead to cirrhosis, such as chronic viral hepatitis (hepatitis B or hepatitis C ).

    Spontaneous peritonitis also occurs in patients who are on peritonealdialysis for kidney failure.

    Peritonitis may also occur due to inflammation, infection, or injury of the intestines. Examples include appendicitis or diverticulitis.

    Symptoms

    • Abdominal pain and bloating
    • Abdominal tenderness
    • Fever
    • Low urine output

    Other symptoms include:

    • Chills
    • Joint pain
    • Nausea and vomiting

    Exams and Tests

    Tests will be done to check for infection and rule out other causes of abdominal pain:

    • Blood culture
    • White blood cell count in a sample of peritoneal fluid
    • Chemical examination of peritoneal fluid
    • Culture of peritoneal fluid
    • CT scan or ultrasound of the abdomen

    Treatment

    Treatment depends on the cause of the peritonitis.

    • Surgery may be needed if peritonitis is caused by a foreign object, such as a catheter used in peritoneal dialysis.
    • Antibiotics may control infection in cases of spontaneous peritonitis with liver or kidney disease.
    • Intravenous therapy can treat dehydration.

    You may need to stay in the hospital so health care providers can rule out other causes of peritonitis, such as appendicitis and diverticulitis.

    Outlook (Prognosis)

    The infection can usually be treated. However, kidney or liver disease may limit recovery.

    Possible Complications

    • Hepatic encephalopathy
    • Hepatorenal syndrome
    • Sepsis

    When to Contact a Medical Professional

    Call your health care provider if you have symptoms of peritonitis. This can quickly become an emergency situation.

    Prevention

    Patients with peritoneal catheters should be treated with sterile techniques. In cases of liver failure, antibiotics may help prevent peritonitis from coming back.Antibiotics may be used to prevent peritonitis if you have acute gastrointestinal bleeding due to certain health conditions.

    References

    Garcia-Tiso G. Cirrhosis and its sequelae. In Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 156.

    Prather C. Inflammatory and anatomic diseases of the intestine, peritoneum, mesentery, and omentum. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 144.

    Runyon BA. Ascites and spontaneous bacterialperitonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa:Saunders Elsevier; 2010:chap 91.

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    • Peritoneal sample

      illustration

      • Peritoneal sample

        illustration

      A Closer Look

        Tests for Peritonitis - spontaneous

          Review Date: 8/10/2012

          Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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