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Causes
By Mayo Clinic staffInfection of the peritoneum can happen for a variety of reasons. In most cases, the cause is a rupture (perforation) in 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 out of your abdomen (paracentesis).
- 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 abdomen.
- 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.
References
- Rangel SJ, et al. Peritonitis. In: Long SS, et al. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7020-3468-8..50075-4&isbn=978-0-7020-3468-8&uniqId=252862957-3#4-u1.0-B978-0-7020-3468-8..50075-4. Accessed May 30, 2011.
- Prasad AG, et al. Peritonitis, secondary. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed May 30, 2011.
- Treating kidney failure with peritoneal dialysis. National Kidney Foundation. http://www.kidney.org/patients/plu/plu_pd/pd_8.cfm. Accessed May 30, 2011.
- Runyon BA. Treatment and prophylaxis of spontaneous bacterial peritonitis. http://www.uptodate.com/home/index.html. Accessed May 30, 2011.
- Acute abdominal pain. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec02/ch011/ch011b.html. Accessed May 30, 2011.
- Fort GG, et al. Peritonitis, spontaneous bacterial. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed May 30, 2011.
- Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. June 13, 2011.
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