Peritonitis - Medical Malpractice Lawyer
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Peritonitis is usually a bacterial infection but can be a fungal infection that infects the peritoneum, which is the thin, silky membrane that lines the entire abdominal wall and the organs of the abdomen. It can occur at any time there is a perforation or rupture in the abdomen, particularly if the perforation occurs in the digestive tract. In some cases, it can result solely from a medical condition such as colitis but this is less common.
Peritonitis is very dangerous and needs prompt medical attention so that the infection and inflammation is under control. The treatment of peritonitis involves the use of antibiotics, steroids, surgery and other supportive medications used until the patient can support himself medically. If untreated or treated too late, the condition can become dire with the potential for loss of life.
It is imperative to know the symptoms of peritonitis so that it can be diagnosed and treated promptly. The main signs and symptoms of peritonitis include the following:
- Distention and feeling bloated in the stomach.
- Having pain and tenderness in the abdominal area.
- Having a fever.
- Having nausea and vomiting.
- Low urine output.
- Being unable to pass stool or gas from the rectum.
It is important to see the doctor or emergency room whenever you develop signs and symptoms of peritonitis, especially nausea and vomiting, fever, abdominal pain and abdominal bloating. A fever can be part of the symptoms you should pay attention to. It can be life threatening if you avoid taking action on these symptoms.
The causes of peritonitis are many. You can have a traumatic perforation of the abdominal wall or perforation of the colon or the rest of the digestive tract during surgery. Medical procedures, such as when doing peritoneal dialysis can cause the disease. A perforated viscus can cause peritonitis. Pancreatitis is inflammation of the pancreas that can cause peritonitis as can diverticulitis, which is a hole spontaneously made in the colon. There is even a condition called spontaneous peritonitis, which can happen in cases of liver disease like cirrhosis. Cirrhosis can involve large amounts of fluid in the abdomen and this fluid is prone to infection.
There are risk factors to getting peritonitis. These include being a patient on peritoneal dialysis and having the following medical conditions:
- Crohn’s disease
- Ulcerative colitis
- Stomach ulcers
- Past history of having peritonitis
Complications of peritonitis include having a bloodstream infection known as bacteremia or sepsis. The sepsis involves an infection that is throughout the body. The body goes through many changes and it can result in organ failure and possible death.
It is important to diagnose peritonitis as quickly as possible to avoid complications. A brief history and physical may point to the diagnosis. Blood can be drawn looking for an elevated white count, usually one that is very high. If sepsis is expected, a blood culture can be done which can show definitively that peritonitis has become sepsis. This is when antibiotics should be given.
A peritoneal fluid analysis can be done using a paracentesis, which can show white blood cells within the peritoneal fluid. Bacteria can show up in the peritoneal fluid as well. Doctors can also do a flat plate x-ray of the abdomen to look for the presence of “free air” which will show that air from the digestive tract has become part of the space outside of the GI tract. This means that a perforation has been detected. A CT scan of the abdomen or an MRI scan can show the presence of abscesses in the abdomen.
The main treatments used in the treatment of peritonitis include strong antibiotics and often multiple antibiotics given as soon as peritonitis is suspected. The antibiotics are usually given by IV means. Surgery is used to remove tissue that has become infected and abscesses, which are collections of bacteria growing together. Of course, there may need to be the need for IV fluids, oxygen therap, blood transfusions and pain medication.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here