Inflammation of the peritoneum, known as peritonitis, is a serious medical condition that can result from a bacterial or fungal infection entering the abdominal cavity.
What is the peritoneum
The peritoneum is a thin layer of tissue that lines the inside of the abdomen, meaning organs such as the stomach, liver, and intestines.
It is composed of two main layers: the parietal peritoneum, which adheres to the inner abdominal wall, and the visceral peritoneum, which covers the organs within the abdomen.
Between the two layers is the peritoneal cavity, which contains peritoneal fluid that serves as a lubricant, allowing organs to slide smoothly against each other during digestion or intestinal movement.
Among the important functions of the peritoneum are organ protection, support of the immune response, and participation in the excretion and absorption of fluids.
Symptoms of peritonitis
Peritonitis can develop for various reasons and may be classified as primary peritonitis, the least common type, which is linked to spontaneous bacterial infections and is often associated with patients who have liver cirrhosis or ascites.
Secondary peritonitis, which is the most common form of this condition, results from a rupture of abdominal organs that allows bacteria or fungi to enter the peritoneal cavity; among the most common causes are appendicitis, abdominal trauma, and a perforated peptic ulcer.
While the symptoms of peritonitis can vary based on the underlying cause, there are certain signs that are most commonly observed:
- Severe abdominal pain: this is the most characteristic symptom and, although initially diffuse, it may become localized to a specific region and worsen with movement.
- Abdominal tenderness: extreme sensitivity when touching the abdomen.
- Abdominal distension: swelling or rigidity may be perceived due to the accumulation of fluids or gases in the peritoneal cavity.
- Fever: since there is infection, it is usually accompanied by moderate or high fever.
- Nausea and vomiting: the normal function of the digestive system may be affected.
- Oliguria or anuria: decreased urine production, which may indicate dehydration or kidney involvement.
In peritonitis, some symptoms may differ depending on the underlying cause or the organ that has been affected. It may also develop gradually as chronic peritonitis, which is rare, or occur suddenly as acute peritonitis.
Signs of peritoneal irritation
If peritonitis is suspected, the doctor will assess for specific signs of peritoneal irritation, which indicate inflammation of the peritoneum.
Identifying these signs helps confirm the suspected diagnosis and guide patient management. Among the main clinical signs of peritoneal irritation are:
- Positive rebound tenderness or Blumberg sign: one of the most classic signs of peritoneal irritation; it consists of gently pressing on the patient’s abdomen and then releasing it abruptly. If the pain worsens upon release, it may indicate peritoneal inflammation.
- Abdominal rigidity: involuntary rigidity of the abdominal muscles is an important sign of peritoneal irritation.
- Absence of bowel sounds: during peritonitis, the intestines often stop moving, a condition known as hypoperistalsis.
These are just some of the signs that help confirm the suspicion of peritonitis, along with the patient’s medical history, laboratory tests, and imaging studies such as ultrasound or computed tomography.
After the diagnosis is confirmed, treatment typically starts with antibiotics to manage the infection, and in cases of secondary peritonitis, surgical intervention may be necessary to address the underlying cause.
It is important to act quickly to avoid the development of sepsis or septic shock, which would require intensive care and constant monitoring.
At ABC Medical Center’s Internal Medicine, we can provide you with specialized care. Contact us!
Fuentes:
Medline Plus, Stanford Children, Scielo
