What causes peritonitis?
Typically, this disorder follows the rupture of an organ in the abdomen, allowing bacteria within the organ to spread into the abdominal cavity. Often caused by a burst appendix or gallbladder, it can also result from a perforation in the wall of the stomach or intestine. Most often, peritonitis is caused by the introduction of an infection from a perforation of the bowel such as a ruptured appendix or diverticulum. Other sources include perforations of the stomach, intestine, gallbladder, or
appendix. Pelvic inflammatory disease in sexually active women is also a common cause of peritonitis. Peritonitis can also develop after surgery when bacteria can enter into the abdomen during an operation.
Primary peritonitis usually occurs in people who have an accumulation of fluid in their abdomens (ascites). Ascites is a common complication of severe cirrhosis of the liver (a disease in which the liver grows increasingly scarred and dysfunctional). The fluid which accumulates creates a good environment for the growth of bacteria.
Secondary peritonitis most commonly occurs when some other medical condition causes bacteria to spill into the abdominal cavity. Bacteria are normal residents of a healthy intestine, but they should have no way to escape and enter the abdomen, where they could cause an infection. Bacteria can infect the peritoneum due to conditions in which a hole (perforation) develops in the stomach (due to an ulcer eating its way through the stomach wall) or intestine (due to a large number of causes, including a ruptured appendix or a ruptured diverticulum). Bacteria can infect the peritoneum due to a severe case of pelvic inflammatory disease (a massive infection of the female organs, including the uterus and fallopian tubes). Bacteria can also escape into the abdominal cavity due to an injury which causes the intestine to burst, or an injury to an internal organ which bleeds into the abdominal cavity.
Sexually active women can develop peritonitis if they suffer from pelvic inflammatory disease - an infection of the uterus and fallopian tubes that can migrate into the abdomen. Peritonitis is also easily triggered by surgical procedures in the abdominal area. For example, leakage can occur during routine procedures in which intestinal segments are joined, or following surgical trauma to the gallbladder, urinary bladder, or intestine. Even the talc or starch on a surgeon's glove can cause peritonitis. In some cases, the inflammation that marks peritonitis develops without an infection, as when an inflamed pancreas leads to the problem. |
