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The peritoneum is a lining of tissue that covers most of the internal organs as well as the inner side of the abdominal wall. Inflammation of the peritoneum is called peritonitis, a serious condition that requires prompt investigation and treatment to avoid complications. It is usually associated with the presence of peritoneal fluid in the space between the lining layers (peritoneal space).

Peritonitis usually occurs when the peritoneum is infected by inflammation or rupture of an organ in the abdomen. This can happen with a traumatic abdominal injury or after surgery It can also occur due to a burst stomach ulcer, burst appendix, perforated colon, diverticulitis (inflammation of intestinal pouches) and pancreatitis. Spontaneous peritonitis occurs when the peritoneal fluid is infected and builds up without rupture of the peritoneum such as in liver cirrhosis or peritoneal dialysis for kidney failure.

With peritonitis, you may experience severe abdominal pain, fever, nausea and vomiting, loss of appetite, fatigue, dizziness, increased thirst and decreased urine output. If you are receiving dialysis, your dialysis fluid may be cloudy or clumpy in appearance. Left untreated, the infection may enter your bloodstream and spread to the rest of your body causing septicaemia, a life-threatening condition that can result in organ failure.

When you present to your doctor or the emergency department with peritonitis, your doctor will review your symptoms and medical history and perform a physical examination along with certain tests. People who experience peritonitis will have tenderness over an inflamed organ or over the whole abdomen if it has ruptured. Blood tests help determine the presence of infection. Imaging studies such as an X-ray or CT scan are performed to view areas of rupture or other abnormalities. Emergency treatment is often required.

Treatment depends on the severity of peritonitis but usually requires a hospital admission. Antibiotics are administered to control infection. Surgery may need to be performed to remove infected tissue such or correct the cause of the peritonitis.