This is an automatically translated article.
The article is professionally consulted by Doctor Vo Thi Thuy Trang - Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International Hospital. Doctor has nearly 20 years of experience in the field of gastroenterology - Hepatobiliary tract.The peritoneum is the largest serosa in the body, and has the function of covering and protecting all the organs in the abdomen. Peritonitis is a serious surgical disease with a high mortality rate and is life-threatening if not treated early.
1. Peritonitis
Peritonitis is a silk-like membrane that covers the inside of the abdominal wall and covers the organs in the abdomen - usually caused by a bacterial or fungal infection. Peritonitis may result from any rupture (or perforation) or may be a complication of another medical condition.Peritonitis requires immediate medical attention to combat the infection and, if necessary, to treat any underlying medical conditions causing the peritonitis. Treatment for peritonitis usually includes antibiotics and in some cases surgery. If left untreated, peritonitis can lead to serious illness, a potentially life-threatening systemic infection.
If you are being treated with peritoneal dialysis (peritoneal dialysis), you can prevent peritonitis by maintaining good hygiene before, during and after peritoneal dialysis.
2. Causes of peritonitis
Infection of the peritoneum can have many causes. In many cases it is due to rupture or perforation of viscera in the abdominal wall. Infection of the peritoneum can also occur without perforation of the abdominal viscera, although this is rarer. This type of peritonitis is called primary peritonitis.Common causes of organ perforation include:
Medical procedures, eg peritoneal dialysis. Peritoneal dialysis uses a tube to remove waste products from the blood when your kidneys are no longer able to do their job properly. Infection can occur during peritoneal dialysis because the area around the tube is not clean, hygiene is poor, or medical equipment is contaminated. Peritonitis can also be a complication of gastrointestinal surgery, the use of feeding tubes, procedures to drain abdominal fluid (lumbar puncture), or, rarely, a complication of colonoscopy. or endoscopy. Perforated appendix, gastric ulcer or colon perforation. Any of these conditions can cause bacteria to enter the peritoneal cavity through a hole in the digestive tract. Pancreatitis . Inflammation of the pancreas complicated by an infection can lead to peritonitis if bacteria spreads outside the pancreas. Gastrointestinal diverticulitis. Infection of the small bulging sacs in the digestive tract (diverticulitis) can cause peritonitis if one of the pouches ruptures, allowing digestive wastes to spill into the abdominal cavity. Injury or injury can cause peritonitis because it allows bacteria or chemicals from other parts of the body to enter the peritoneal cavity. Primary peritonitis often occurs as a result of complications of liver disease, such as cirrhosis. Advanced cirrhosis produces a large amount of fluid inside the abdominal cavity (ascites). This accumulation of fluid is favorable for bacterial infection.
3. Why is peritonitis dangerous?
Peritonitis is a very serious disease in surgery, if not treated promptly, the mortality rate can be up to 60-70%. Because acute peritonitis is the final stage of the intra-abdominal infection process, while there are many types of bacteria, their toxicity is very high, while the area of the peritoneum (peritoneum) is very large. so the ability to absorb toxins from empty organs (stomach, intestines...) overflows, toxins (secreted by bacteria) very quickly, easily leading to shock and poisoning (septic shock).Severe disease is also due to the ease of spreading throughout the abdomen by peristalsis (colic contractions push the dirt into the abdomen). Therefore, when suspected of having peritonitis, it is necessary to diagnose early, treat correctly and promptly to limit mortality to the maximum extent.
4. Symptoms
Signs and symptoms of peritonitis include:Abdominal pain, peritoneal tenderness; Abdominal distention or so to speak is a feeling of distension of the abdomen; Fever; Nausea and vomiting; Anorexia; Diarrhea; Decreased urine output; Thirsty; Constipation or defecation; Tired. If you are on peritoneal dialysis, the symptoms of peritonitis will be accompanied by: Cloudy dialysis fluid; Appearance of white spots, fibers or nodules (fibrin) in the filtrate. Peritonitis can be life-threatening if not treated early. Contact your doctor immediately if you have severe abdominal pain or abdominal pain when palpating or feeling fullness in the abdomen and are accompanied by:
Fever Nausea and vomiting Decreased urine output Thirst Passing or defecation If sick If you are on peritoneal dialysis, tell your doctor right away if the filtrate is cloudy or has white spots, fibers or nodules (fibrin) or it has an unusual odor, especially if the area around the tube is red or painful. .
5. Risk factors
Factors that increase the risk of peritonitis include:Peritoneal dialysis. Peritonitis is common in people undergoing peritoneal dialysis. Other diseases. The following conditions may increase the risk of peritonitis: Cirrhosis, appendicitis, Crohn's disease, peptic ulcer, diverticulitis, and pancreatitis. History of peritonitis. If you've had peritonitis in the past, you're more likely to get it again than someone who hasn't.
6. Complications
If left untreated, peritonitis can cause an infection outside the peritoneal cavity:Bacteremia (bacteria that enter the bloodstream); Sepsis (Sepsis). Sepsis progresses rapidly, becoming life-threatening with shock and organ failure. Peritonitis is a very serious surgical disease with a high mortality rate. Because peritonitis is the final process of intra-abdominal infection, when there are abnormal manifestations, it is necessary to go to a medical facility to be examined and have the earliest treatment.
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