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Peritonitis - spontaneous bacterial

Spontaneous bacterial peritonitis (SBP); Ascites - peritonitis; Cirrhosis - peritonitis

 

The peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the organs. Peritonitis is present when this tissue becomes inflamed or infected.

Spontaneous bacterial peritonitis (SBP) is present when this tissue becomes infected and there is no clear cause.

Causes

 

SBP is most often caused by infection in fluid that collects in the peritoneal cavity (ascites). The fluid buildup often occurs with advanced liver or kidney disease.

Risk factors for liver disease include:

  • Very heavy alcohol use
  • Chronic hepatitis B or hepatitis C
  • Other diseases that lead to cirrhosis

SBP also occurs in people who are on peritoneal dialysis for kidney failure.

Peritonitis may have other causes. These include infection from other organs or leakage of enzymes or other toxins into the abdomen.

 

Symptoms

 

Symptoms include:

  • 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 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 SBP.

  • Surgery may be needed if SBP is caused by a foreign object, such as a catheter used in peritoneal dialysis.
  • Antibiotics to control infection.
  • Fluids given through the veins.

You will need to stay in the hospital so health care providers can rule out other causes such as a ruptured appendix and diverticulitis.

 

Outlook (Prognosis)

 

In most cases, the infection can be treated. However, kidney or liver disease may limit recovery.

 

Possible Complications

 

Complications may include:

  • Loss of brain function occurs when the liver is unable to remove toxins from the blood.
  • Kidney problem caused by liver failure.
  • Sepsis.

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of peritonitis. This can be a medical emergency situation.

 

Prevention

 

Steps should be taken to prevent infection in people with peritoneal catheters.

Antibiotics may be used:

  • To prevent peritonitis from coming back in people with liver failure
  • To prevent peritonitis in people who have acute gastrointestinal bleeding due to other conditions

 

 

References

Garcia-Tiso G. Cirrhosis and its sequelae. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 153.

Kuemmerle JF. Inflammatory and anatomic diseases of the intestine, peritoneum, mesentery, and omentum. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 142.

Runyon BA. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 93.

 
  • Peritoneal sample

    Peritoneal sample - illustration

    The peritoneum is the membrane lining the abdominal cavity.

    Peritoneal sample

    illustration

    • Peritoneal sample

      Peritoneal sample - illustration

      The peritoneum is the membrane lining the abdominal cavity.

      Peritoneal sample

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Peritonitis - spontaneous bacterial

         

           

          Review Date: 5/11/2016

          Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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