Peritonitis

Diagnosis

To diagnose peritonitis, your health care provider talks with you about your medical history and gives you a physical exam. Your symptoms alone may be enough for your provider to diagnose the condition if your peritonitis is linked to peritoneal dialysis.

If more tests are needed to confirm a diagnosis, your health care provider may suggest:

• Blood tests. A sample of your blood may be taken to see if you have an increase in disease-fighting white blood cells. This is usually a sign of an infection or inflammation. You also might have a blood culture test to find out if bacteria are in your blood.
• Imaging tests. You may have an X-ray exam to check for holes or other tears in your digestive tract. You also may have a test that uses sound waves to make images inside your body, called ultrasound. In some cases, you may have a CT scan.
• Peritoneal fluid analysis. In this test, a thin needle is used to take a sample of the fluid in your peritoneum. You're more likely to have this test if you get peritoneal dialysis or if you have fluid in your abdomen from liver disease. An increased white blood cell count in this fluid usually points to an infection or inflammation. A culture of the fluid may be used to spot bacteria.

Treatment

Spontaneous bacterial peritonitis can be life-threatening. You'll need to stay in the hospital. Treatment includes antibiotics. It also includes supportive care to ease your symptoms.

You'll also need to stay in the hospital for secondary peritonitis. Treatment may include:

• Antibiotics. You'll likely take antibiotic medicine through a needle in a vein. This clears out the infection and keeps it from spreading. The type of antibiotic you'll need and how long you'll have to take it will vary. It depends on how serious your condition is and the kind of peritonitis you have.
• Surgery. This is often needed to remove infected tissue, treat the cause of the infection, and prevent the infection from spreading. Surgery is important if your peritonitis is due to a ruptured appendix, stomach or colon.
• Other treatments. Depending on your symptoms, your treatment while in the hospital will likely include:
  • Pain medications.
  • Fluids given through a tube, called intravenous fluids.
  • Oxygen.
  • In some cases, a blood transfusion.

If you get peritoneal dialysis

If you have peritonitis, your health care provider may suggest that you receive dialysis in another way. You may need this other type of dialysis for several days while your body heals from the infection. If your peritonitis lingers or comes back, you may need to stop having peritoneal dialysis completely and switch to a different type of dialysis.