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Tests and diagnosis
By Mayo Clinic staffTo diagnose peritonitis, your doctor will talk with you about your medical history and perform a physical exam. When peritonitis is associated with peritoneal dialysis, your signs and symptoms, particularly cloudy dialysis fluid, may be enough for your doctor to diagnose the condition.
In cases of peritonitis in which the infection may be a result of other medical conditions (secondary peritonitis) or in which the infection arises from fluid buildup in your abdominal cavity (spontaneous peritonitis), your doctor may recommend the following tests to confirm a diagnosis:
- Peritoneal fluid analysis. Using a thin needle, your doctor may take a sample of the fluid in your peritoneum (paracentesis). If you have peritonitis, examination of this fluid may show an increased white blood cell count, which typically indicates an infection or inflammation. A culture of the fluid may also reveal the presence of bacteria.
- Blood tests. A sample of your blood may be drawn and sent to a lab to check for a high white blood cell count. A blood culture also may be performed to determine if there are bacteria in your blood.
- Imaging tests. Your doctor may want to use an X-ray to check for holes or other perforations in your gastrointestinal tract. Ultrasound may also be used. In some cases, your doctor may use a computerized tomography (CT) scan instead of an X-ray.
The above tests may also be necessary if you're receiving peritoneal dialysis and a diagnosis of peritonitis is uncertain after a physical exam and an examination of the dialysis fluid.
- 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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