From the Guidelines
Peritonitis is primarily caused by bacterial or fungal infections that reach the peritoneal cavity, with the most common causes including gastrointestinal perforation, abdominal trauma, surgical complications, and peritoneal dialysis catheter infections. The infection can be classified into primary, secondary, or tertiary peritonitis, with secondary peritonitis being the most common form, resulting from loss of integrity of the gastrointestinal tract or from infected viscera 1. Some of the specific causes of peritonitis include:
- Gastrointestinal perforation (from peptic ulcers, appendicitis, diverticulitis, or bowel obstruction)
- Abdominal trauma
- Surgical complications, such as anastomotic dehiscences
- Peritoneal dialysis catheter infections
- Spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites
- Pancreatitis with enzyme leakage
- Gynecological infections like pelvic inflammatory disease
- Chemical irritation from bile or gastric acid leakage
The etiological factors of peritonitis show a wide geographical variation and different spectrum in various regions of the world, with the sources of infection summarized in the recent international WISS Study 1. The infection triggers an inflammatory response in the peritoneal membrane, causing symptoms like severe abdominal pain, fever, nausea, and abdominal distension. Prompt treatment with appropriate antibiotics targeting the specific pathogens (commonly E. coli, Klebsiella, Streptococcus, or Staphylococcus species) and addressing the underlying cause is essential to prevent life-threatening complications like sepsis and multiple organ failure 1.