Peritonitis

Peritonitis is a serious condition where the lining inside your abdomen and pelvis gets inflamed. The peritoneum is a thin, silky tissue that covers:

• your stomach
• your liver
• other organs in your abdomen (belly)
• the inner wall of your abdomen

Peritonitis is life-threatening and needs immediate medical treatment.

The most common symptom of peritonitis is severe abdominal pain that gets worse when you move. This makes you want to lie still.

Other common symptoms may include:

• a bloated belly
• fever
• nausea and vomiting
• loss of appetite
• diarrhoea
• feeling tired
• thirst and low urine (wee) output

Some people with peritonitis have few or no symptoms.

What are the warning signs?

Warning signs of peritonitis that need immediate medical attention include:

• sudden and severe belly pain
• high fever
• hard or swollen belly
• difficulty passing wind or having a bowel movement

If you or someone you know has symptoms of peritonitis, it is important to seek urgent medical care. Peritonitis can be life-threatening and needs urgent treatment.

Peritonitis is the inflammation of the lining of your abdomen and is usually caused by a bacterial infection.

Bacteria can enter the abdomen from:

• a burst appendix
• a hole in the bowel (such as from diverticulitis)
• a stomach (peptic) ulcer
• a ruptured (burst) ectopic pregnancy
• surgery or an injury
• peritoneal dialysis
• pelvic inflammatory disease — where bacteria, often from a sexually transmitted infection (STI), enter through your vagina and reach the peritoneum in your pelvis

Spontaneous bacterial peritonitis

If you have liver cirrhosis, you may have a build-up of fluid in your abdomen, called ascites. This fluid may become infected, and doctors may not know where the bacteria came from. This is called spontaneous bacterial peritonitis.

It can also happen in children with nephrotic syndrome (a type of kidney disease).

Your doctor will ask about your symptoms and medical history. They will also do a physical examination.

Your doctor may refer you for tests, including:

• blood tests — to check for inflammation or bacteria in your bloodstream
• imaging tests — an ultrasound or computed tomography (CT) scan may be used to check for any holes or tears in the digestive tract
• peritoneal fluid analysis — a sample of fluid will be removed from your abdomen and tested

If you are diagnosed with peritonitis, you will need to stay in hospital for treatment, often in an intensive care unit.

Treatment may include:

• antibiotics given through an IV (a needle in your vein) to fight the infection quickly
• surgery — if peritonitis is caused by a hole in an organ, such as a burst appendix, surgery can fix the hole and clean out the infection
• drainage of any pockets of pus (abscesses) in your abdomen using a needle guided by an ultrasound or CT scan

If you are having peritoneal dialysis and have peritonitis that doesn't get better or keeps coming back, you may need to switch to a different type of dialysis.

Peritonitis can lead to serious complications if not treated quickly, such as:

• fluid build-up — fluid can collect in the abdomen, leading to dehydration
• sepsis — the infection can spread throughout the body, causing severe and widespread inflammation
• organ damage — sepsis can slow blood flow and reduce oxygen to your organs, which may lead to organ failure or even death

You can help prevent peritonitis by reducing your risk of infections. It is also important to manage underlying conditions that could lead to peritonitis. Talk to your doctor to find out how to protect yourself.

If you have severe liver disease, you may need to take long-term antibiotics to prevent peritonitis.

If you are having peritoneal dialysis, it’s important to keep your catheter site clean. Wash your hands well whenever you handle your catheter.

Sepsis Australia (Opens in new tab) provides information and support to people who have sepsis and their carers.

Visit the Liver Foundation (Opens in new tab) to find out about preventing infection if you are living with chronic liver disease.

Information for Aboriginal and/or Torres Strait Islander peoples

NACCHO (Opens in new tab) helps you find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.