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Medically reviewed by Last updated on Nov 5, 2023.

What is peritonitis?

Peritonitis is an infection in the lining that covers your abdomen and organs, called the peritoneum. Spontaneous peritonitis happens when fluid in the peritoneum becomes infected. Secondary peritonitis happens after an injury or surgery in your abdomen. A peritonitis infection can become life-threatening.

What increases my risk for peritonitis?

  • A bacterial or fungal infection
  • A rupture in your abdomen, such as a ruptured appendix or stomach ulcer
  • A medical procedure such as peritoneal dialysis done in an unclean environment
  • Surgery in your abdomen, or an injury to your abdomen
  • Use of a feeding tube
  • Pancreatitis (inflamed pancreas) or diverticulitis (infection in the intestine) that causes bacteria to spread
  • Advanced cirrhosis (liver disease) causing fluid buildup that becomes infected with bacteria

What are the signs and symptoms of peritonitis?

  • Pain or tenderness in your abdomen, with stiff abdominal muscles
  • Feeling full or bloated
  • Fever or fatigue
  • Nausea, vomiting, diarrhea, or loss of appetite
  • Urinating less than usual, a dry, swollen tongue, or more thirst than usual
  • Trouble having a bowel movement or passing gas
  • Dialysis fluid that is cloudy or has white flecks (peritoneal dialysis)

How is peritonitis diagnosed?

Your healthcare provider will ask about your symptoms and when they began. If you are receiving peritoneal dialysis, your provider may check the fluid to see if it is cloudy or has flecks. You may need any of the following:

  • Blood tests are used to check your white blood cell (WBC) count. An increase in WBCs may be a sign of infection. Your blood may also be tested for bacteria or a fungus.
  • X-ray, ultrasound, or CT pictures may be taken of your chest or abdomen. The pictures may show problems such as a hole or tear in your gastrointestinal tract. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • Paracentesis is a procedure used to take a sample of fluid through a needle. The fluid is checked for increased WBCs or bacteria.

How is peritonitis treated?

You may need to be treated in the hospital if the infection is severe. Your healthcare provider will treat the cause of your peritonitis and help relieve symptoms. If you are receiving peritoneal dialysis, your provider may recommend a different kind of dialysis until your body heals. You may need to receive a different kind of dialysis permanently if you develop peritonitis again after treatment. You may also need any of the following:

  • Medicines may be given to lower pain or to fight a bacterial infection. You may also need medicines to relieve nausea or to stop vomiting.
  • Surgery may be needed to remove infected tissue or to close a hole. This will prevent the infection from spreading to other parts of your body. Surgery may also be used to drain an abscess.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

When should I seek immediate care?

  • You have severe pain in your abdomen that keeps you from being comfortable.
  • You have severe tenderness in your abdomen.
  • You have severe abdominal pain after you have an accident or are injured.
  • You are receiving peritoneal dialysis and the dialysis fluid is cloudy or has flecks or clumps.

When should I call my doctor?

  • You have a fever.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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