Peritoneal inflammation, also known as peritonitis, is a condition characterized by irritation and swelling of the peritoneum. This thin tissue acts as a protective lining for the abdominal cavity and its organs. The inflammation typically arises from an infection, often bacterial, or exposure to irritating bodily fluids. Prompt medical attention is necessary for this condition, as it can escalate rapidly and potentially affect surrounding abdominal organs or spread throughout the bloodstream.
Understanding the Peritoneum and Inflammation
The peritoneum is a serous membrane, a smooth sheet of tissue that lines the abdominopelvic cavity and surrounds most abdominal organs. It consists of two layers: the parietal peritoneum, which lines the abdominal and pelvic walls, and the visceral peritoneum, which wraps around the organs themselves. Between these layers lies the peritoneal cavity, a potential space containing a small amount of serous fluid. This fluid acts as a lubricant, allowing organs to glide smoothly against each other during movement like digestion and breathing, reducing friction.
Beyond lubrication, the peritoneum serves several functions, including providing insulation through layers of fat, offering structural support by connecting organs and suspending intestines, and supplying nerves and blood vessels. It also plays a role in immunity, acting as a barrier against injury and pathogens entering the abdominal cavity. Inflammation, the body’s natural response to injury or infection, involves increased blood flow and immune cell movement. When this occurs within the peritoneum, it signals a problem requiring assessment.
Common Causes
Peritoneal inflammation frequently results from the introduction of infection or irritating substances into the normally sterile peritoneal environment. A common cause is the perforation of a part of the gastrointestinal tract, allowing bacteria to leak into the abdominal cavity. This can occur from conditions such as a burst appendix, a perforated stomach ulcer, or a perforated intestinal ulcer due to diverticulitis or inflammatory bowel disease.
Other medical conditions can also lead to peritoneal inflammation. Pancreatitis, an inflamed pancreas, can cause enzymes to leak into the peritoneum, leading to irritation. Pelvic inflammatory disease in women, where bacteria from a sexually transmitted infection reach the peritoneum, may also result in inflammation. Additionally, certain medical procedures or trauma, such as abdominal surgery or injuries like knife wounds, can introduce bacteria or fluids into the peritoneal cavity, triggering an inflammatory response. Spontaneous bacterial peritonitis (SBP) is another type, often seen in individuals with ascites (fluid buildup in the abdomen), where bacteria can infect the accumulated fluid.
Symptoms to Watch For
The signs and symptoms of peritoneal inflammation can vary, but typically include severe abdominal pain and tenderness. This pain often worsens with motion or when the abdomen is touched, leading individuals to prefer lying still. The abdomen may also appear bloated or distended due to fluid accumulation or gas.
Accompanying these abdominal symptoms, a person might experience systemic signs of infection or inflammation. Fever and chills are common as the body fights off the underlying cause. Nausea and vomiting are frequently reported, along with a loss of appetite. Changes in bowel habits, such as diarrhea, constipation, or an inability to pass gas, can also occur because the infection may hinder the normal movements of the intestines. Other indicators include excessive thirst and reduced urine output, which may suggest dehydration.
How Peritoneal Inflammation is Diagnosed and Treated
Diagnosing peritoneal inflammation typically begins with a thorough physical examination, where the abdomen may feel hard and tender, and the individual might guard the area due to pain. Imaging tests, such as X-rays and computed tomography (CT) scans, are often used to identify any perforations or fluid collections within the abdomen. CT scans with contrast are particularly sensitive for detecting inflammation and abscesses, and for determining the underlying cause.
Laboratory tests also play a role in diagnosis. Blood tests, including a complete blood count (CBC), can reveal a high white blood cell count, indicating infection or inflammation. A blood culture may be performed to identify the specific bacteria causing the infection. If there is fluid accumulation in the abdomen, a procedure called paracentesis may be performed, where a needle is used to remove a fluid sample for analysis and culture to identify infectious agents.
Treatment for peritoneal inflammation usually requires hospitalization and immediate medical intervention. Intravenous (IV) antibiotics are typically administered promptly to combat bacterial infections and prevent their spread. Pain management and intravenous fluids are also provided to support the patient and address dehydration. In many cases, surgical intervention is necessary to address the source of the inflammation, such as repairing a perforated organ like a burst appendix or stomach ulcer, or draining abscesses.
Potential Health Complications
If peritoneal inflammation is not treated promptly, it can lead to several serious health complications. One significant risk is sepsis, a severe, body-wide inflammatory response that occurs when the infection spreads into the bloodstream. Sepsis can cause a widespread inflammatory reaction, potentially leading to reduced blood flow, decreased oxygen delivery to tissues, and organ damage. In severe cases, this can progress to septic shock, which can result in multiple organ failure and be life-threatening.
Fluid can accumulate in the abdomen, leading to dehydration and imbalances in electrolytes, which are essential minerals in the body. This fluid buildup can also temporarily paralyze organs, causing issues like constipation or urine retention. Another potential complication is the formation of abdominal adhesions, which are bands of scar tissue that can develop from the inflammation. These adhesions can sometimes obstruct the bowels, requiring further medical intervention.