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</a><h1 class="with-also" itemprop="name">Peritonitis - secondary</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>The peritoneum is the thin tissue that lines the inner wall of the abdomen and covers most of the organs in the abdomen. Peritonitis is present when this tissue becomes inflamed or infected. Secondary peritonitis is when another condition is the cause.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Secondary peritonitis has several major causes.</p><ul><li>Bacteria may enter the peritoneum through a hole (perforation) in an organ of the digestive tract. The hole may be caused by a ruptured appendix, stomach ulcer, or perforated colon. It may also come from an injury, such as a gunshot or knife wound or following the ingestion of a sharp foreign body.</li><li><a test="test" href="./002237.htm">Bile</a> or chemicals released by the pancreas may leak into the abdominal cavity. This may be caused by <a test="test" href="./000287.htm">swelling and inflammation of the pancreas</a> called pancreatitis.</li><li>Tubes or catheters placed into the abdomen may cause this problem. These include catheters for peritoneal dialysis, feeding tubes, and others.</li></ul><p>An infection of the bloodstream (sepsis) may lead to an infection in the abdomen also. This is a severe illness.</p><p>This tissue may become infected when there is no clear cause.</p><p><a test="test" href="./001148.htm">Necrotizing enterocolitis</a> occurs when the lining of the intestinal wall dies and can lead to peritonitis. This problem nearly always develops in an infant who is ill or born early.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms include:</p><ul><li><a test="test" href="./003122.htm">Swollen abdomen</a> when your belly area is bigger than usual</li><li><a test="test" href="./003120.htm">Abdominal pain</a></li><li>Decreased appetite</li><li><a test="test" href="./003090.htm">Fever</a></li><li><a test="test" href="./003147.htm">Low urine output</a></li><li>Nausea</li><li><a test="test" href="./003085.htm">Thirst</a></li><li>Vomiting</li></ul><p>Note: There may be signs of <a test="test" href="./000039.htm">shock</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>During a physical exam, the health care provider may find abnormal <a test="test" href="./002341.htm">vital signs</a> with fever, <a test="test" href="./003077.htm">rapid heart rate</a> and breathing, low blood pressure, and a tender distended abdomen.</p><p>Tests may include:</p><ul><li><a test="test" href="./003744.htm">Blood culture</a></li><li>Blood chemistry, including pancreatic enzymes</li><li>Complete blood count</li><li>Liver and kidney function tests</li><li>X-rays or CT scan</li><li><a test="test" href="./003727.htm">Peritoneal fluid culture</a>, Gram stain and chemistry tests</li><li>Urinalysis </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Often, surgery is needed to remove or treat sources of infection. These may be an infected bowel, an inflamed appendix, or an <a test="test" href="./001353.htm">abscess</a> or perforated diverticulum, usually due to diverticulitis.</p><p>General treatment includes:</p><ul><li>Antibiotics</li><li>Fluids through a vein (IV)</li><li>Pain medicines</li><li>Tube through the nose into the stomach or intestine (nasogastric or NG tube) </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The outcome can range from complete recovery to overwhelming infection and death. Factors that determine the outcome include:</p><ul><li>How long the symptoms were present before treatment began</li><li>The person's general health </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Abscess</li><li>Gangrene (dead) bowel requiring surgery</li><li>Intraperitoneal <a test="test" href="./001493.htm">adhesions</a> (a potential cause of future bowel blockage)</li><li><a test="test" href="./000668.htm">Septic shock</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if you have symptoms of <a test="test" href="./001335.htm">peritonitis</a>. This is a serious condition. It needs emergency treatment in most cases.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Secondary peritonitis</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/8715t.jpg" alt="Peritoneal sample" title="Peritoneal sample" class="side-img"/><a href="../imagepages/8715.htm">Peritoneal fluid sample</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Mathews JB, Turaga K. Surgical peritonitis and other diseases of the peritoneum, mesentery, omentum, and diaphragm. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 39.</p><p>Privratsky AM, Barreto JC, Turnage RH, Mizell J, Badgwell B. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. <em>Sabiston Textbook of Surgery</em>. 21st ed. St Louis, MO: Elsevier; 2022:chap 44.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 6/11/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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