Infection of the peritoneum can happen for a variety of reasons. In most cases, the cause is a rupture (perforation) within the abdominal wall. Though it’s rare, the condition can develop without an abdominal rupture. This type of peritonitis is called spontaneous peritonitis.
Common causes of ruptures that lead to peritonitis include:
- Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis also may develop as a complication of gastrointestinal surgery, the use of feeding tubes or a procedure to withdraw fluid from your abdomen (paracentesis) and rarely as a complication of colonoscopy or endoscopy.
- A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract.
- Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spread outside the pancreas.
- Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulitis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity.
- Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum.
Peritonitis that develops without an abdominal rupture (spontaneous peritonitis) is usually a complication of liver disease, such as cirrhosis. Advanced cirrhosis causes a large amount of fluid buildup in your abdominal cavity (ascites). That fluid buildup is susceptible to bacterial infection.
March 31, 2015
- Long SS, et al. Peritonitis. In: Principles and Practice of Pediatric Infectious Diseases. 4th ed. St. Louis, Mo.: Elsevier Saunders; 2012. http://www.clinicalkey.com. Accessed March 12, 2015.
- Ferri FF. Peritonitis, secondary. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed March 12, 2015.
- Treatment methods for kidney failure: Peritoneal dialysis. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). http://kidney.niddk.nih.gov/KUDiseases/pubs/peritoneal/index.aspx. Accessed March 13, 2015.
- Runyon BA. Spontaneous bacterial peritonitis in adults: Treatment and prophylaxis. http://www.uptodate.com/home. Accessed March 12, 2015.
- Acute abdominal pain. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/gastrointestinal_disorders/acute_abdomen_and_surgical_gastroenterology/acute_abdominal_pain.html?qt=&sc=&alt=. Accessed March 12, 2015.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. March 24, 2015.
- Doherty GM, ed. Peritoneal Cavity. In: Current Diagnosis & Treatment: Surgery. 13th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com. Accessed March 13, 2015.
- Goel GA, et al. Increased rate of spontaneous bacterial peritonitis among cirrhotic patients receiving pharmacologic acid suppression. Clinical Gastroenterology and Hepatology. 2012;10:422.
- Burkart JM, et al. Tunnel and peritoneal catheter exit site infections in continuous peritoneal dialysis. http://www.uptodate.com/home. Accessed March 13, 2015.