CHECK-UP:Secondary peritonitis happens when another infection spreads, as a result of a ruptured appendix, writes MARION KERR
OUR 18 year old became very unwell with severe stomach pain and a high temperature. When he was admitted to hospital through A&E he was diagnosed with peritonitis secondary to a burst appendix. What is peritonitis?
Peritonitis is inflammation and infection of the abdominal cavity and its lining. Secondary peritonitis means the infection is the result of another condition, such as an infection spreading from the digestive tract.
This is usually the result of bacteria entering the peritoneum through a perforation in the gastrointestinal tract as a result of a ruptured appendix, stomach ulcer or perforated colon. It may also occur following a penetrating injury, such as a gunshot or knife wound. In other cases it can develop when chemicals produced by the pancreas leak into the lining of the abdominal cavity.
During the use of peritoneal dialysis catheters, foreign contaminants can leak into the peritoneal cavity, causing peritonitis. It can also occur following abdominal surgery or in those with liver or heart failure when fluid accumulates in the abdominal cavity and becomes infected.
Inflammation of the peritoneal cavity caused by bacteria can cause infection of the bloodstream (sepsis) and severe illness.
What other symptoms can you get with this condition?
Symptoms of peritonitis vary from person to person but can include abdominal pain, abdominal distension and high temperature. Nausea and vomiting with a loss of appetite for food and severe thirst are also common symptoms of peritonitis. A decrease in the volume of urine produced may also be experienced. In severe infection, the person may go into shock and show signs of rapid heart rate and breathing as well as a significant drop in blood pressure.
How is it diagnosed?
Diagnosis is usually made using a range of investigations which may include blood tests as well as liver and kidney tests. CT scans, X-rays and laboratory examination of a sample of the fluid from the peritoneal may also be necessary to confirm the diagnosis.
Unless treated promptly, complications can develop rapidly. Treatment will depend on the cause of the infection but may include the use of antibiotics, intravenous fluids and pain killers. Surgery may be necessary to remove sources of infection such as an infected bowel, inflamed appendix or abscess.
The outcome of treatment will depend on the underlying cause of the infection, the duration of symptoms before treatment, and the general health of the patient.