AskDefine | Define peritonitis

Dictionary Definition

peritonitis n : inflammation of the peritoneum [syn: peritoneal inflammation]

User Contributed Dictionary

English

Noun

peritonitis
  1. Inflammation of the peritoneum, especially when caused by an infectious organism introduced into the abdominal cavity

Extensive Definition

This article is concerned with peritonitis in human beings. For a specific cause of peritonitis in cats, see feline infectious peritonitis.
Peritonitis is defined as inflammation of the peritoneum (the serous membrane which lines part of the abdominal cavity and some of the viscera it contains). It may be localised or generalised, generally has an acute course, and may depend on either infection (often due to rupture of a hollow viscus) or on a non-infectious process. Peritonitis generally represents a surgical emergency.

Mechanisms and manifestations

Abdominal pain and tenderness

The main manifestations of peritonitis are acute abdominal pain, tenderness, and guarding, which are exacerbated by moving the peritoneum, e.g. coughing, flexing the hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits no pain, but releasing the hand abruptly will aggravate the pain, as the peritoneum snaps back into place). The localization of these manifestations depends on whether peritonitis is localized (e.g. appendicitis or diverticulitis before perforation), or generalized to the whole abdomen; even in the latter case, pain typically starts at the site of the causing disease. Peritonitis is an example of acute abdomen.

Collateral manifestations

Complications

Diagnosis and investigations

A diagnosis of peritonitis is based primarily on clinical grounds, that is on the clinical manifestations described above; if they support a strong suspicion of peritonitis, no further investigation should delay surgery. Leukocytosis and acidosis may be present, but they are not specific findings. Plain abdominal X-rays may reveal dilated, oedematous intestines, although it is mainly useful to look for pneumoperitoneum (free air in the peritoneal cavity), which may also be visible on chest X-rays. If reasonable doubt still persists, an exploratory peritoneal lavage may be performed (e.g. in cause of trauma, in order to look for white blood cells, red blood cells, or bacteria).

Causes

Infected peritonitis

Non-infected peritonitis

Treatment

Depending on the severity of the patient's state, the management of peritonitis may include:

Prognosis

If properly treated, typical cases of surgically correctable peritonitis (e.g. perforated peptic ulcer, appendicitis, and diverticulitis) have a mortality rate of about <10% in otherwise healthy patients, which rises to about 40% in the elderly, and/or in those with significant underlying illness, as well as in cases that present late (after 48h). If untreated, generalised peritonitis is almost always fatal.

Pathology

The peritoneum normally appears greyish and glistening; it becomes dull 2-4 hours after the onset of peritonitis, initially with scarce serous or slightly turbid fluid. Later on, the exudate becomes creamy and evidently suppurative; in dehydrated patients, it also becomes very inspissated. The quantity of accumulated exudate varies widely. It may be spread to the whole peritoneum, or be walled off by the omentum and viscera. Inflammation features infiltration by neutrophils with fibrino-purulent exudation.

References

peritonitis in Arabic: التهاب الصفاق
peritonitis in Catalan: Peritonitis
peritonitis in Danish: Peritonitis
peritonitis in German: Peritonitis
peritonitis in Spanish: Peritonitis
peritonitis in French: Péritonite
peritonitis in Italian: Peritonite
peritonitis in Dutch: Buikvliesontsteking
peritonitis in Japanese: 腹膜炎
peritonitis in Polish: Zapalenie otrzewnej
peritonitis in Portuguese: Peritonite
peritonitis in Russian: Перитонит
peritonitis in Finnish: Peritoniitti
peritonitis in Swedish: Bukhinneinflammation
peritonitis in Turkish: Periton
peritonitis in Chinese: 腹膜炎

Synonyms, Antonyms and Related Words

abdominal hernia, adenoiditis, adrenitis, appendicitis, arteritis, arthritis deformans, arthritis fungosa, arthritis pauperum, atrophic arthritis, atrophic inflammation, blennorrhagic arthritis, brain fever, bronchitis, bunion, bursitis, capillaritis, carditis, catarrh, catarrhal inflammation, cerebellitis, cerebral meningitis, cerebritis, cerebrospinal meningitis, chronic infectious arthritis, chronic inflammation, cirrhotic inflammation, climactic arthritis, clitoritis, colitis, collagen disease, conjunctivitis, cystitis, degenerative arthritis, diffuse inflammation, diverticulitis, diverticulosis, duodenal ulcer, duodenitis, encephalitis, endocarditis, enteritis, equine encephalomyelitis, esophagal ulcer, esophagitis, exudative inflammation, fibroid inflammation, focal inflammation, gastritis, gingivitis, glossitis, gonococcal arthritis, gonorrheal arthritis, gonorrheal rheumatism, gout, gouty arthritis, hemophilic arthritis, hepatitis, hiatal hernia, hyperplastic inflammation, hypertrophic arthritis, hypertrophic inflammation, infectional arthritis, infectious hepatitis, inflammation, irritable bowel syndrome, laryngitis, lumbago, lumbar rheumatism, mastoiditis, megacolon, meningitis, menopausal arthritis, metastatic inflammation, metritis, milk leg, mucous colitis, mumps meningitis, myelitis, necrotic inflammation, nephritis, neuritis, obliterative inflammation, ophthalitis, ophthalmia, orchitis, osseous rheumatism, osteitis, osteoarthritis, osteomyelitis, otitis, ovaritis, paradental pyorrhea, penitis, peptic ulcer, pericarditis, periodontitis, pharyngitis, phlebitis, podagra, polyp, proliferative arthritis, prostatitis, pyonephritis, pyorrhea, pyorrhea alveolaris, reactive inflammation, rheumatism, rheumatiz, rheumatoid arthritis, rhinitis, sclerosing inflammation, seroplastic inflammation, serous inflammation, serum hepatitis, simple inflammation, sinusitis, spastic colon, specific inflammation, stomach ulcer, subacute rheumatism, suppurative arthritis, suppurative inflammation, syphilitic arthritis, tennis elbow, testitis, thrombophlebitis, tonsilitis, torticollis, toxic inflammation, traumatic inflammation, tuberculous arthritis, tuberculous rheumatism, ulcer, ulcerative colitis, uratic arthritis, ureteritis, urethral arthritis, urethritis, uteritis, vaginitis, vertebral arthritis, visceral rheumatism, vulvitis, wryneck
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