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Peritonitis is an inflammation of the peritoneum, the tissue lining the abdominal cavity, primarily caused by bacterial or fungal infections.
These infections can arise from conditions such as a ruptured appendix, stomach ulcer, or intestinal perforation, which allow harmful bacteria to enter the abdominal cavity. Immediate treatment is necessary to prevent complications, including sepsis and organ failure.
There are three primary types of peritonitis, each distinguished by its underlying cause and progression.
This type occurs without a direct cause within the abdomen and often affects individuals with liver disease and ascites, where bacteria from the intestines spread to the peritoneal fluid.
This type results from a rupture or injury in the abdomen, such as a burst appendix or perforated ulcer, which allows bacteria from the digestive tract to infect the peritoneum.
This is a persistent infection that recurs after treatment for primary or secondary peritonitis, typically affecting individuals with weakened immune systems or critical illnesses.
Peritonitis can occur due to various factors that introduce bacteria into the abdominal cavity. Common causes include:
Recognising the symptoms of peritonitis is necessary for timely treatment. Common symptoms include:
Diagnosing peritonitis involves several key methods to confirm infection and determine the best course of treatment.
The doctor will check for abdominal tenderness, rigidity, and swelling, which are key signs of inflammation and potential infection in the abdominal cavity.
Blood tests detect elevated white blood cell counts and other infection markers, indicating an immune response to infection in the abdominal cavity and aiding diagnosis.
X-rays may reveal free air in the abdomen, a sign of organ perforation associated with secondary peritonitis. Ultrasound or CT scans identify fluid collections or abscesses, helping to assess the infection’s severity and spread.
If there is fluid in the abdomen, a peritoneal fluid sample may be collected for analysis. Testing for bacteria or inflammatory cells confirms infection and helps guide treatment.
Consult our MOH-accredited specialist for an accurate diagnosis & personalised treatment plan today.
Treatment for peritonitis depends on its cause and severity, with both non-surgical and surgical options available.
Intravenous antibiotics are commonly prescribed as the first line of treatment, which help control the infection and reduce inflammation. Completing the full course of antibiotics is essential to ensure the infection is fully cleared and to reduce the risk of recurrence.
Over-the-counter pain relievers, such as paracetamol, may be used to alleviate discomfort during recovery.
In severe cases of peritonitis, especially when complications such as organ rupture or abscesses occur, surgery may be required to prevent further issues and eliminate the source of infection.
This often involves repairing or removing the affected organ, such as the appendix or a segment of the intestine. This procedure helps prevent further contamination of the abdominal cavity.
If abscesses form, they may need to be drained. This is typically performed using ultrasound or CT imaging guidance. The drainage can be done through a needle or a small incision to remove infected fluid, reducing pain and preventing the infection from spreading.
Preventing peritonitis involves managing risk factors, particularly for those with chronic conditions. Effective management of diseases like liver disease and diabetes can help lower the risk of developing peritonitis. Adhering to hygiene protocols during peritoneal dialysis is important to prevent infections. Timely treatment of abdominal infections or injuries, such as appendicitis or diverticulitis, is also key in avoiding complications. Overall, early intervention for these underlying issues can reduce the likelihood of developing peritonitis.
MBBS (S’pore)|
M.Med (Surgery)|
MRCS (Ireland)|
FRCS (Edin)|
王健名医生
Dr. Calvin Ong is a Senior Consultant with more than 15 years of surgical experience. He specializes in colorectal and general surgery, performing minimally invasive as well as advanced robotic surgeries for benign and malignant colorectal conditions, including inflammatory bowel disease, pelvic floor disorders, colorectal cancer, and hernia repair. He is dedicated to providing high-quality, personalised care for his patients.
Dr. Ong graduated with a Bachelor’s degree in medicine and surgery from the National University of Singapore in 2008 and completed his Masters of Medicine (Surgery) at the same institute. He finished his advanced specialist training in 2016 and became a fellow of the Royal College of Surgeons of Edinburgh.
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Untreated peritonitis can lead to severe complications, including sepsis, multi-organ failure, and bowel obstructions caused by scar tissue. In extreme cases, it can be life-threatening.
Yes, particularly in individuals with chronic conditions like liver disease. In these cases, preventive antibiotics and regular check-ups may help reduce the risk of recurrence.
Recovery time varies based on infection severity and treatment type. Patients undergoing surgery or extensive antibiotic therapy may require several weeks to fully recover, especially if complications arise.