Secondary peritonitis is an inflammation of the thin tissue that lines the inner wall of the abdomen and covers most of the abdominal organs. It is called the peritoneum.
Secondary means it is due to another condition. It is most often caused by an infection that spreads from the digestive tract.
Secondary peritonitis has several major causes. Bacteria may enter the peritoneum through a hole (perforation) in the gastrointestinal tract. The hole may be caused by a ruptured appendix, stomach ulcer, or perforated colon. It may also come from an injury, such as a gunshot or knife wound.
Secondary peritonitis can also occur when bile or chemicals released by the pancreas (pancreatic enzymes) leak into the lining of the abdominal cavity.
Substances from outside the body can also cause secondary peritonitis if they get into the peritoneal cavity. This can occur during use of peritoneal dialysis catheters or feeding tubes.
Inflammation of the peritoneal cavity caused by bacteria can cause an infection of the bloodstream (sepsis). This is a severe illness.
Secondary peritonitis can also affect premature babies who have necrotizing enterocolitis.
Note: There may be signs of shock.
Tests may include:
Often, surgery is needed to remove sources of infection. These may be an infected bowel, an inflamed appendix, or an abscess.
General treatment includes:
The outcome can range from complete recovery to overwhelming infection and death. Factors that determine the outcome include:
Call your health care provider if you have symptoms of peritonitis. This is a serious condition. It needs emergency medical treatment in most cases.
Turnage RH, Badgwell B. McDonald JC. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 45.
Wyers SG, Matthews JB. Surgical peritonitis and other diseases of the peritoneum, mesentery, omentum, and diaphragm. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 37.
Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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