Materiały źródłowe

• #1 Peritonitis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/17831-peritonitis

  Peritonitis can be mild to severe, and it can be localized in one place or diffuse throughout your peritoneum. […] Your symptoms may vary depending on the type of peritonitis you have. They usually include abdominal pain and swelling. […] Symptoms of peritonitis include stomach pain and swelling. The most common symptoms of peritonitis are stomach pain and swelling. If you have an infection, you may also have nausea and fever. […] Typical symptoms include mild to severe abdominal pain and sensitivity to touch. […] If you have an infection, you may also have fever, nausea and vomiting, fast heart rate, and shortness of breath. […] Yes, it’s possible. Abdominal pain and other symptoms from the original condition that causes your peritonitis can disguise the symptoms of peritonitis itself. […] Your outlook depends on the cause and type of peritonitis you have and how quickly it’s treated. Early recognition is important to be able to control peritonitis before it becomes complicated.

• #1 Peritonitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peritonitis/symptoms-causes/syc-20376247

  Symptoms of peritonitis include: Belly pain or tenderness. Bloating or a feeling of fullness in the abdomen. Fever. Upset stomach and vomiting. Loss of appetite. Diarrhea. Reduced urine. Thirst. Not able to pass stool or gas. Feeling tired. Confusion. […] If you get peritoneal dialysis, peritonitis symptoms also may include: Cloudy dialysis fluid. White flecks, strands or clumps which are called fibrin in the dialysis fluid. […] Peritonitis can be life-threatening if you don’t get treatment quickly. Call your health care provider right away if you have severe pain or tenderness of your abdomen, bloating or a feeling of fullness along with: Fever. Upset stomach and vomiting. Reduced urine. Thirst. Not able to pass stool or gas. […] Peritonitis that happens without a hole or tear is called spontaneous bacterial peritonitis. It’s usually a complication of liver disease, such as cirrhosis. Advanced cirrhosis causes a lot of fluid buildup in your abdomen. That fluid buildup could lead to a bacterial infection.

• #1 29.13A: Peritonitis – Medicine LibreTexts

  https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Anatomy_and_Physiology_(Boundless)/29%3A_APPENDIX_A%3A_Diseases_Injuries_and_Disorders_of_the_Organ_Systems/29.13%3A_Diseases_and_Disorders_of_the_Digestive_System/29.13A%3A_Peritonitis

  The main manifestations of peritonitis are acute abdominal pain, abdominal tenderness, and abdominal guarding, which are exacerbated by moving the peritoneum by coughing, flexing ones hips, or eliciting the Blumberg sign. […] Other symptoms include fever, sinus tachycardia, and development of intestinal paralysis, which also causes nausea, vomiting, and bloating. […] Complications of peritonitis include sequestration of fluid and electrolytes, as revealed by decreased central venous pressure, which may cause electrolyte disturbances, as well as significant hypovolemia, possibly leading to shock and acute renal failure. […] If properly treated, typical cases of surgically correctable peritonitis (e.g., perforated peptic ulcer, appendicitis, and diverticulitis) have a mortality rate of less than 10%. […] If untreated, generalized peritonitis is almost always fatal.

• #1 Peritonitis Causes, Stages, Symptoms, Diagnosis, Treatment

  https://www.medicinenet.com/peritonitis/article.htm

  Abdominal Pain The signs and symptoms of peritonitis may vary depending on the cause of the inflammation. […] Most individuals need quick or emergent treatment of peritonitis because infecting organisms can spread rapidly in individuals and become life-threatening. […] The signs and symptoms of peritonitis may vary depending on the cause of the inflammation; however, there are relatively common indicators that suggest a person may have peritonitis. […] People usually have abdominal discomfort and one or more of the following: Abdominal tenderness or pain, Abdominal tenderness or pain that increases when the abdomen is touched or moved (palpation), Abdominal swelling (bloating or distention), Fever, Chills, Nausea, Vomiting, Diarrhea, Decreased urination, Loss of appetite (anorexia), Fatigue and/or weakness, Constipation, Inability to pass gas, Ascites (fluid in the abdominal cavity), Unexplained encephalopathy (new-onset mental changes).

• #1 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  Anorexia and nausea are frequent symptoms and may precede the development of abdominal pain. Vomiting may be due to underlying visceral organ pathology (ie, obstruction) or be secondary to peritoneal irritation. […] On physical examination, patients with peritonitis generally appear unwell and in acute distress. Many of them have a temperature that exceeds 38 C, although patients with severe sepsis may become hypothermic. Tachycardia may be present, as a result of the release of inflammatory mediators, intravascular hypovolemia from anorexia, vomiting and fever, and third-space losses into the peritoneal cavity. With progressive dehydration, patients may become hypotensive (5-14% of patients), as well as oliguric or anuric; with severe peritonitis, they may present in overt septic shock.

• #1 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  When examining the abdomen of a patient with suspected peritonitis, the patient should be supine. A roll or pillows underneath the patient’s knees may allow for better relaxation of the abdominal wall. […] On abdominal examination, almost all patients demonstrate tenderness to palpation. In most patients even those with generalized peritonitis and severe diffuse abdominal pain the point of maximal tenderness or referred rebound tenderness roughly overlies the pathologic process (ie, the site of maximal peritoneal irritation). […] Most patients demonstrate increased abdominal wall rigidity. The increase in abdominal wall muscular tone may be voluntary, in response to or in anticipation of the abdominal examination, or involuntary because of the peritoneal irritation. Patients with severe peritonitis often avoid all motion and keep their hips flexed to relieve the abdominal wall tension. The abdomen is often distended, with hypoactive-to-absent bowel sounds. This finding reflects a generalized ileus and may not be present if the infection is well localized. Occasionally, the abdominal examination reveals an inflammatory mass.

• #1 Peritonitis: Symptoms, Causes, Treatments, and More

  https://www.healthline.com/health/peritonitis

  Symptoms will vary depending on the underlying cause of your infection. Common symptoms of peritonitis include: tenderness in your abdomen […] pain in your abdomen that gets more intense with motion or touch […] abdominal bloating or distention […] nausea and vomiting […] diarrhea […] constipation or the inability to pass gas […] minimal urine output […] anorexia, or loss of appetite […] excessive thirst […] fatigue […] fever and chills. […] If treatment doesn’t begin early, the infection can spread. If other organs are damaged, your recovery will depend on your overall health and how much damage was done.

• #1 Peritonitis – Symptoms, Causes, Diagnosis and Treatment | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/peritonitis-symptoms-causes-diagnosis-and-treatment

  The common symptoms of peritonitis include: Pain in the abdomen […] A feeling of fullness or bloating […] Appetite loss […] Fatigue along with confusion […] Diarrhea and low output of urine […] Difficulty in the passage of stool […] In the case of patients receiving peritoneal dialysis therapy, the symptoms also include: Dialysis fluid is of an unusual color with white flecks […] Dialysis fluid contains clumps of fibrin […] Dialysis fluid has an unusual odor. Peritonitis, if left untreated, can lead to sepsis, a life-threatening infection. Peritonitis that develops due to the accumulation of body fluids requires 24-48 hours to develop.

• #1 Peritonitis: symptoms, causes, treatments, diagnosis and stages

  https://www.kidneyresearchuk.org/conditions-symptoms/peritonitis/

  The vast majority of PD peritonitis is very mild and easily treated with episodes typically less than one every two years. […] Signs and symptoms of peritonitis can include: […] PD fluid that is cloudy or has visible white flecks – this is the most common and important sign and must be reported as soon as it is noticed. […] Abdominal pain – if experienced, always check if the fluid is cloudy […] Redness, pain or swelling at the catheter site – this should always be reported to the PD team […] Nausea and vomiting […] Rapid heartbeat […] Swollen abdomen […] High temperature […] Rigors: a medical term for episodes of severe shivering and a feeling of coldness. […] In severe cases, repeated bouts of infection can damage the peritoneum and cause thickening of the tissue (sclerosis) which can prevent peritoneal dialysis from working properly. Deaths are very rare and usually associated with underlying abdominal pathology.

• #1 Peritonitis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/peritonitis

  Peritonitis is the inflammation of abdominal membranes, most commonly due to bacterial infection. […] Peritonitis is life threatening if not treated promptly. […] The symptoms of peritonitis include: Severe and constant abdominal pain, Fever, Inability to break wind or pass stools, Nausea and vomiting, Shock. […] Peritonitis is life threatening without prompt medical treatment. The infection stops the normal movements of the intestines (peristalsis). […] A person with untreated peritonitis can die within a few days.

• #1 Peritonitis Causes, Stages, Symptoms, Diagnosis, Treatment

  https://www.medicinenet.com/peritonitis/article.htm

  Generally, peritonitis is classified into three stages based on the progression and severity of the condition. These three stages include the following: Acute peritonitis, Peritoneal abscess, Diffuse peritonitis. […] The initial stage of peritonitis is characterized by a sudden onset of symptoms. […] Symptoms of acute peritonitis include: Abdominal pain, Tenderness, Swelling, Fever, Nausea, Vomiting, Difficulty having a bowel movement. […] Acute peritonitis can develop into a peritoneal abscess if left untreated. […] This stage is characterized by pus accumulation in the abdominal cavity, creating an abscess. […] Symptoms of a peritoneal abscess include: Fever, Chills, Increased abdominal pain. […] Peritonitis progresses to the third stage, known as diffuse peritonitis if the infection continues to spread. […] This stage is characterized by widespread inflammation, as well as damage to the peritoneum and surrounding organs. […] Symptoms of diffuse peritonitis include: Severe abdominal pain, Fever, Vomiting, Signs of sepsis.

• #1 Peritonitis

  https://www.icliniq.com/articles/gastro-health/peritonitis-symptoms-causes-and-treatment

  Inflammation of the tissue that lines the inner wall of the abdomen (peritoneum) is called peritonitis. The most common symptom of peritonitis is severe pain in the abdomen which should be immediately reported to medical professionals to seek help and prevent some potentially fatal complications. If it is left untreated, it can be spread rapidly into the blood and other vital organs, which can lead to multiple organ failures and death. […] Initially, peritonitis shows poor or loss of appetite and nausea (uneasiness in the stomach, often felt before vomiting), and mild abdominal pain. Gradually the symptoms turn to persistent severe abdominal pain, which has the potential to worsen by any movement. […] Other than these symptoms, peritonitis may also show the following symptoms – Chills: A sudden feeling of cold felt by the body. Fever: Increase in body temperature. Abdominal Tenderness: Pain felt in the abdomen area when even little pressure is applied. Fluid in the abdomen – Ascites. Less urination or no urine is passed from the body. Troubled bowel movements or difficulty in passing gas. Vomiting. Peritonitis can result in fatal complications such as sepsis (infection in the blood), further leading to septic shock. Shock can cause a massive drop in blood pressure, organ failure, and eventually death. […] During the initial stages, the pain will be mild. But as the condition progresses, the pain increases in intensity. There will be difficulty in passing stool and gas. Bloating or feeling of fullness can also be observed.

• #1 Generalized peritonitis lead to shock: Diagnosis and management

  https://jjgastro.com/articles/JJGR-v1-1004.html

  Abdominal pain is the most common symptom of peritonitis. Pain usually comes with a sudden onset, is severe and in patients with perforation the pain is found in all parts of the abdomen. As the disease progresses, the pain is constant, unrelenting, a burning feeling and arises with various movements. Pain is usually more pronounced in the area where the peritoneum is inflamed. A decrease in the intensity and spread of pain indicates a localization of the inflammatory process, when the increasing intensity with the expansion of the pain area indicates the spread of peritonitis. […] In severe peritonitis the Hippocrates fascies can be found. These symptoms include a visibly restless expression, a blank gaze, cowong eyes, cold ears, and a pale face. Patients with advanced peritonitis with Hippocratic fascies are usually in the pre-terminal stage. It is characterized by their lying position with their knees flexed and limited intercostal respiration because any movement can cause pain in the abdomen. This sign is pathognomonic for severe peritonitis with a high mortality rate, but knowing earlier the diagnosis and better treatment can reduce the mortality rate more.

• #1 Peritonitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/peritonitis

  The signs and symptoms of peritonitis include: Swelling and tenderness in the abdomen with pain ranging from dull aches to severe, sharp pain […] Fever and chills […] Loss of appetite […] Thirst […] Nausea and vomiting […] Less urine […] Not being able to pass gas or stool. […] Peritonitis is an emergency and can be life threatening. Your doctor will do a physical examination to see whether you need surgery to fix the underlying problem. The doctor will feel and press your abdomen to find any swelling and tenderness, and look for signs that fluid has collected in the area. […] The prognosis for peritonitis depends on the type of the condition. The outlook for people with secondary peritonitis tends to be poor, especially among: The elderly […] People with weakened immune systems […] Those who have had symptoms for longer than 48 hours before treatment. […] The long-term outlook for people with primary peritonitis due to liver disease also tends to be poor. However, the prognosis for primary peritonitis among children is usually very good after treatment with antibiotics.

• #1 Peritonitis – symptoms, causes and treatment | healthdirect

  https://www.healthdirect.gov.au/peritonitis

  If you or someone you know has any symptoms of peritonitis, it is important to seek urgent medical care. Peritonitis can be life-threatening and requires fast treatment. […] Quick medical treatment may prevent serious problems such as infection spreading throughout the body. […] If you are diagnosed with peritonitis, you will need to stay in hospital for treatment, often in an intensive care unit. […] Peritonitis can lead to serious complications if not treated quickly, such as: fluid buildup, sepsis, organ damage.

• #1 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  The diagnosis of peritonitis is usually clinical. History should include recent abdominal surgery, previous episodes of peritonitis, travel history, use of immunosuppressive agents, and the presence of diseases (eg, inflammatory bowel disease, diverticulitis, peptic ulcer disease) that may predispose to intra-abdominal infections. […] A broad range of signs and symptoms are seen in spontaneous bacterial peritonitis (SBP). A high index of suspicion must be maintained when caring for patients with ascites, particularly those with acute clinical deterioration. As many as 30% of patients are completely asymptomatic. Manifestations of SBP may include the following: Fever and chills (as many as 80% of patients), Abdominal pain or discomfort (found in as many as 70% of patients), Worsening or unexplained encephalopathy, Diarrhea, Ascites that does not improve following administration of diuretic medication, Worsening or new-onset renal failure, Ileus.

• #1 Spontaneous bacterial peritonitis in adults: Clinical manifestations – UpToDate

  https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-clinical-manifestations

  Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically-treatable source; it primarily occurs in patients with advanced cirrhosis. Typically, it is suspected when patients present with signs or symptoms of SBP (eg, fever, abdominal pain). […] An elevated ascitic fluid absolute PMN count (≥250 cells/mm³) is adequate to make a presumptive diagnosis of SBP and to start empiric therapy. […] It is important to recognize spontaneous bacterial peritonitis early in the course of infection because there is frequently a very short window of opportunity during which to intervene to ensure a good outcome. If the opportunity is missed, shock ensues, followed rapidly by multisystem organ failure. […] Patients with spontaneous bacterial peritonitis (SBP) typically have advanced cirrhosis. The higher the Model for End-stage Liver Disease (MELD) score, the higher the risk of SBP.

• #2 Peritonitis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/peritonitis

  Peritonitis is the inflammation of abdominal membranes, most commonly due to bacterial infection. […] Peritonitis is life threatening if not treated promptly. […] The symptoms of peritonitis include: Severe and constant abdominal pain, Fever, Inability to break wind or pass stools, Nausea and vomiting, Shock. […] Peritonitis is life threatening without prompt medical treatment. The infection stops the normal movements of the intestines (peristalsis). […] A person with untreated peritonitis can die within a few days.

• #2 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  Abdominal pain, which may be acute or insidious, is the usual chief complaint of patients with peritonitis. Initially, the pain may be dull and poorly localized (visceral peritoneum); often, it progresses to steady, severe, and more localized pain (parietal peritoneum). Abdominal pain may be exacerbated by any movement (eg, coughing, flexing the hips) and local pressure. If the underlying process is not contained, the pain becomes diffuse. In certain disease entities (eg, gastric perforation, severe acute pancreatitis, intestinal ischemia), the abdominal pain may be generalized from the beginning. […] Abdominal distention may be noted, as well as signs of dysfunction of other organs. Symptoms may be subtle in patients on corticosteroids, in diabetic patients with advanced neuropathy, and in hospitalized patients, especially the very young and the very old. In the presence of ascites, decreased friction between the visceral and parietal peritoneal surfaces may reduce the symptoms of abdominal pain, as seen in patients with SBP.

• #2 Peritonitis: Causes, Symptoms and Treatments.

  https://www.webmd.com/digestive-disorders/peritonitis-symptoms-causes-treatments

  Peritonitis symptoms often start with belly pain that gets worse. You might also be bloated, from fluid buildup in your abdomen. […] The first symptoms of peritonitis are often poor appetite, nausea, and a dull belly ache. The dull ache can quickly turn into persistent, severe abdominal pain that gets worse when you move. […] Other signs and symptoms may include: A tender, bloated belly, Chills, Fever, Trouble peeing, Trouble passing gas or pooping, Vomiting, Thirst, Confusion, Fast heart rate, Shortness of breath, Easy bruising, Swollen legs and feet (edema). […] If you get peritoneal dialysis, symptoms also may include: Cloudy dialysis fluid, White flecks, strands, or clumps in the dialysis fluid.

• #2 Peritonitis – symptoms, causes and treatment | healthdirect

  https://www.healthdirect.gov.au/peritonitis

  If you feel unwell and have severe abdominal pain, especially if you have chronic liver disease, call triple zero (000) for an ambulance or go to a hospital emergency department. […] Peritonitis is a life-threatening inflammation of the lining of your abdomen. […] Symptoms include severe abdominal pain, bloating, fever, nausea and a hard or swollen belly. […] The most common symptom of peritonitis is severe abdominal pain that gets worse with movement. This makes you want to lie still. […] Other common symptoms may include: a bloated belly, fever, nausea and vomiting, loss of appetite, diarrhoea, feeling tired, thirst and low urine (wee) output. […] Warning signs of peritonitis that need immediate medical attention include: sudden and severe belly pain, high fever, hard or swollen belly, difficulty passing wind or having a bowel movement.

• #2 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  Anorexia and nausea are frequent symptoms and may precede the development of abdominal pain. Vomiting may be due to underlying visceral organ pathology (ie, obstruction) or be secondary to peritoneal irritation. […] On physical examination, patients with peritonitis generally appear unwell and in acute distress. Many of them have a temperature that exceeds 38 C, although patients with severe sepsis may become hypothermic. Tachycardia may be present, as a result of the release of inflammatory mediators, intravascular hypovolemia from anorexia, vomiting and fever, and third-space losses into the peritoneal cavity. With progressive dehydration, patients may become hypotensive (5-14% of patients), as well as oliguric or anuric; with severe peritonitis, they may present in overt septic shock.

• #2 Peritonitis

  https://www.nhs.uk/conditions/peritonitis/

  Symptoms of peritonitis include: tummy pain, a very high temperature, or feeling hot and shivery, a rapid heartbeat (your heart is beating more quickly than normal), not being able to pee or peeing much less than normal. […] You might also have: a lack of appetite and feel or be sick, a swollen tummy. […] Urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if: you have symptoms of peritonitis. […] Serious complications like sepsis can happen if the infection spreads.

• #2 Peritonitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/peritonitis

  Your belly is very painful or tender. The pain may become worse when your belly is touched or when you move. […] Your belly may look or feel bloated. This is called abdominal distention. […] Other symptoms may include: Fever and chills, Passing little or no stools or gas, Excessive fatigue, Passing less urine, Nausea and vomiting, Racing heartbeat, Shortness of breath.

• #2 Peritonitis – Dr. Sulaiman Yusof

  https://drsulaiman.com.sg/peritonitis/

  Appetite loss is common due to abdominal pain, nausea, and overall digestive disruption. The body may naturally avoid eating to relieve digestive strain on already irritated and inflamed tissues. […] The bodys response to infection and inflammation stresses the system, resulting in a faster heartbeat and breathing. These may also indicate early signs of sepsis, where infection spreads to the bloodstream. […] A severe infection can affect overall body function, causing fatigue and confusion. This is especially common if the infection has started affecting multiple systems, signalling potential sepsis.

• #2 Peritonitis Causes, Stages, Symptoms, Diagnosis, Treatment

  https://www.medicinenet.com/peritonitis/article.htm

  Abdominal Pain The signs and symptoms of peritonitis may vary depending on the cause of the inflammation. […] Most individuals need quick or emergent treatment of peritonitis because infecting organisms can spread rapidly in individuals and become life-threatening. […] The signs and symptoms of peritonitis may vary depending on the cause of the inflammation; however, there are relatively common indicators that suggest a person may have peritonitis. […] People usually have abdominal discomfort and one or more of the following: Abdominal tenderness or pain, Abdominal tenderness or pain that increases when the abdomen is touched or moved (palpation), Abdominal swelling (bloating or distention), Fever, Chills, Nausea, Vomiting, Diarrhea, Decreased urination, Loss of appetite (anorexia), Fatigue and/or weakness, Constipation, Inability to pass gas, Ascites (fluid in the abdominal cavity), Unexplained encephalopathy (new-onset mental changes).

• #2 Septic Peritonitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526129/

  Sepsis secondary to peritonitis occurs when the abdominal cavity becomes infected, leading to a systemic inflammatory response. […] The condition typically results from perforation or infection within the gastrointestinal tract and can rapidly escalate into severe sepsis or septic shock. Early identification and management are crucial to prevent further complications, including multi-organ failure. […] Concerning signs present in a high percentage of individuals with diagnosed peritonitis include vague constitutional symptoms such as fever, chills, abdominal pain, discomfort, diarrhea, and ileus. Approximately 30% of individuals with spontaneous bacterial peritonitis are asymptomatic on presentation. […] Patients present with a variable amount of clinical manifestation of the underlying disease process, ranging from insidious mild limited disease to an acute fulminant systemic process.

• #2 Peritonitis – Wikipedia

  https://en.wikipedia.org/wiki/Peritonitis

  Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. […] One part or the entire abdomen may be tender. […] Complications may include shock and acute respiratory distress syndrome. […] The main manifestations of peritonitis are acute abdominal pain, abdominal tenderness, abdominal guarding, rigidity, which are exacerbated by moving the peritoneum. […] Diffuse abdominal rigidity (abdominal guarding) is often present, especially in generalized peritonitis. […] Fever. […] Development of ileus paralyticus (i.e., intestinal paralysis), which also causes nausea, vomiting and bloating. […] Reduced or no passage of abdominal gas and bowel sound. […] If properly treated, typical cases of surgically correctable peritonitis have a mortality rate of about 10% in otherwise healthy people.

• #2 Peritonitis: symptoms, causes, treatments, diagnosis and stages

  https://www.kidneyresearchuk.org/conditions-symptoms/peritonitis/

  The vast majority of PD peritonitis is very mild and easily treated with episodes typically less than one every two years. […] Signs and symptoms of peritonitis can include: […] PD fluid that is cloudy or has visible white flecks – this is the most common and important sign and must be reported as soon as it is noticed. […] Abdominal pain – if experienced, always check if the fluid is cloudy […] Redness, pain or swelling at the catheter site – this should always be reported to the PD team […] Nausea and vomiting […] Rapid heartbeat […] Swollen abdomen […] High temperature […] Rigors: a medical term for episodes of severe shivering and a feeling of coldness. […] In severe cases, repeated bouts of infection can damage the peritoneum and cause thickening of the tissue (sclerosis) which can prevent peritoneal dialysis from working properly. Deaths are very rare and usually associated with underlying abdominal pathology.

• #2 Peritonitis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/312552

  Peritonitis is a serious and urgent condition that requires immediate treatment. Symptoms include sudden, severe abdominal pain. […] The symptoms of peritonitis are serious. They need urgent medical attention in a nearby emergency room or an ambulance callout. […] The main symptom is sudden, severe stomach pain that gets worse. […] Some effects of peritonitis are related to serious effects in the body such as dehydration and shock. Other symptoms include: fever, nausea and vomiting, diarrhea, loss of appetite, fast heart rate, inability to pass stool or gas, and difficulties passing urine. […] A swollen abdomen is also a symptom of peritonitis. When a rupture causes peritonitis, fluid fills the abdominal cavity and the bowel, resulting in loss of fluid from the rest of the body. This causes the worst dehydration effects of peritonitis. […] Without prompt treatment, peritonitis can lead to more dangerous conditions such as sepsis and septic shock. As a result, the condition can quickly become life-threatening.

• #2 Peritonitis – symptoms, treatment, signs and clinical guidelines

  https://en.medicina.ru/for-patients/diseases/peritonitis/

  The main symptoms of serous peritonitis and other manifestations are similar. It is more important to understand the phases – there are three of them: […] At this stage, inflammation intensifies, the infection spreads more strongly, dysfunction of various organs is observed (multiple organ dysfunction); […] The last stage, in the absence of professional help, leads to the death of the patient – that is why it is extremely important to catch the symptoms of peritonitis as early as possible and go to the hospital and call an ambulance. […] The symptoms may vary depending on the phase. So, at the first stage (reactive phase), the symptoms of peritonitis are as follows: stomach ache. They become stronger when a person inhales or begins to move. It is more comfortable for the patient to lie in the fetal position or on the back; an increase in temperature (up to 38 degrees and above) is a symptom of intoxication; weakness, irritability, agitation – an obvious change in state; tachycardia, increased heart rate (100-120 beats), as well as more frequent breathing; nausea, vomiting – these symptoms are less common.

• #2 Peritonitis – symptoms, treatment, signs and clinical guidelines

  https://en.medicina.ru/for-patients/diseases/peritonitis/

  With the development of the toxic phase, the patient’s condition becomes even worse – there are signs of severe intoxication, bloating, severe pain, pallor. […] The terminal phase of acute peritonitis involves the depletion of all body reserves. Clouding of consciousness begins, the skin often changes color to yellow, the temperature drops below normal. The patient is often not in himself, does not react to surrounding stimuli. […] Without urgent medical intervention, peritonitis is a condition that will lead to the death of the patient.

• #2 Generalized peritonitis lead to shock: Diagnosis and management

  https://jjgastro.com/articles/JJGR-v1-1004.html

  In some severe cases, shock can occur due to two factors. First due to the movement of intravascular fluid into the peritoneal cavity or to the lumen from the intestines. The second is due to generalized sepsis. The mainstay of septicemia in generalized peritonitis involves Gram-negative bacteria which can produce a shock-like stage. […] Vital signs are very useful in assessing the degree of severity or complications that arise in peritonitis. In a state of metabolic acidosis, it can be seen from the respiratory rate that is faster than normal as a compensation mechanism to return to normal. Tachycardia, reduced peripheral pulse volume and narrowed pulse pressure can indicate hypovolemic shock. […] The most obvious sign in patients with peritonitis is distension of the abdomen. However, the absence of signs of abdominal distension does not exclude the diagnosis of peritonitis, especially if the patient is examined early in the course of the disease, because within 2-3 days there will be signs of abdominal distension. This occurs as a result of a buildup of fluid exudate but most abdominal distension results from paralytic ileus.

• #2 Spontaneous Bacterial Peritonitis(Archived) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448208/

  There is a short window of opportunity for treating SBP before it progresses to septic shock or multisystem organ failure; therefore, rapid assessment and diagnosis are critical (i.e., treatment is much more successful if antibiotics are started before the development of shock). […] The infection-related mortality in SBP is very low with appropriate treatment. However, the mortality rate is quite high in those patients who develop sepsis. But with appropriate antibiotic therapy, better outcomes can be achieved. In hospital settings, the non-infection-related mortality in SBP patients can be as high as 20-40 percent, and one to two years of mortality rates are 70 and 80 percent, respectively. […] Spontaneous bacterial peritonitis carries a mortality rate of 30 to 70% in patients with end-stage liver and kidney disease. The mortality rates are lower in children with nephrosis. Recently the mortality rates have shown a slight decrease because of earlier diagnosis and advances in treatment. For the patient who develops septic shock secondary to bacterial peritonitis, the mortality increases each hour until antibiotic therapy is started.

• #2 Peritonitis

  https://www.mymlc.com/health-information/diseases-and-conditions/p/peritonitis2/

  Left untreated, peritonitis can extend beyond your peritoneum, where it may cause: an infection throughout your body (sepsis). Sepsis is a rapidly progressing, life-threatening condition that can cause shock, organ failure and death. […] Spontaneous bacterial peritonitis can be life-threatening. You’ll need to stay in the hospital. Treatment includes antibiotics and supportive care. […] You’ll also need to stay in the hospital for peritonitis that’s caused by infection from other medical conditions (secondary peritonitis). Treatment may include: antibiotics, surgery, other treatments.

• #2 29.13A: Peritonitis – Medicine LibreTexts

  https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Anatomy_and_Physiology_(Boundless)/29%3A_APPENDIX_A%3A_Diseases_Injuries_and_Disorders_of_the_Organ_Systems/29.13%3A_Diseases_and_Disorders_of_the_Digestive_System/29.13A%3A_Peritonitis

  The main manifestations of peritonitis are acute abdominal pain, abdominal tenderness, and abdominal guarding, which are exacerbated by moving the peritoneum by coughing, flexing ones hips, or eliciting the Blumberg sign. […] Other symptoms include fever, sinus tachycardia, and development of intestinal paralysis, which also causes nausea, vomiting, and bloating. […] Complications of peritonitis include sequestration of fluid and electrolytes, as revealed by decreased central venous pressure, which may cause electrolyte disturbances, as well as significant hypovolemia, possibly leading to shock and acute renal failure. […] If properly treated, typical cases of surgically correctable peritonitis (e.g., perforated peptic ulcer, appendicitis, and diverticulitis) have a mortality rate of less than 10%. […] If untreated, generalized peritonitis is almost always fatal.

• #2 Peritonitis and Abdominal Sepsis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/180234-clinical

  Remember that the presentation and the findings on clinical examination may be entirely inconclusive or unreliable in patients with significant immunosuppression (eg, severe diabetes, steroid use, posttransplant status, HIV infection), in patients with altered mental state (eg, head injury, toxic encephalopathy, septic shock, analgesic agents), in patients with paraplegia, and in patients of advanced age. With localized deep peritoneal infections, fever and/or an elevated WBC count may be the only signs present. As many as 20% of patients with spontaneous bacterial peritonitis demonstrate very subtle signs and symptoms. New onset or deterioration of existing encephalopathy may be the only sign of the infection at the initial presentation. Most patients with tuberculous peritonitis demonstrate vague symptoms and may be afebrile.

• #2 Spontaneous Bacterial Peritonitis (SBP) – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/spontaneous-bacterial-peritonitis-sbp

  Patients have symptoms and signs of ascites. Discomfort is usually present; it typically is diffuse, constant, and mild to moderate in severity. […] Signs of SBP may include fever, malaise, encephalopathy, worsening hepatic failure, and unexplained clinical deterioration. Peritoneal signs (eg, abdominal tenderness and rebound) are present but may be somewhat diminished by the presence of ascitic fluid.

• #2 Spontaneous bacterial peritonitis in adults: Diagnosis – UpToDate

  https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-diagnosis

  Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source. The presence of SBP, which almost always occurs in patients with cirrhosis and ascites, is suspected because of suggestive signs and symptoms, such as fever, abdominal pain, or altered mental status, though some patients are asymptomatic and are detected when they undergo paracentesis after being admitted to the hospital for another reason. […] Spontaneous bacterial peritonitis (SBP) should be suspected in patients with cirrhosis who develop signs or symptoms such as fever, abdominal pain, altered mental status, abdominal tenderness, or hypotension. In addition, patients with ascites admitted to the hospital for other reasons should also undergo paracentesis to look for evidence of SBP. A low clinical suspicion for SBP does not obviate the need for testing.

• #2 Septic Peritonitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526129/

  Fluid analysis is important for the diagnosis of spontaneous bacterial peritonitis, with the most sensitive indicator being a neutrophil count greater than 250 cells/microliter. […] The primary focus of management is identifying and treating the offending agent(s) via antibiotics and/or surgical intervention.

• #3 Peritonitis: Causes, Symptoms and Treatments.

  https://www.webmd.com/digestive-disorders/peritonitis-symptoms-causes-treatments

  Peritonitis symptoms often start with belly pain that gets worse. You might also be bloated, from fluid buildup in your abdomen. […] The first symptoms of peritonitis are often poor appetite, nausea, and a dull belly ache. The dull ache can quickly turn into persistent, severe abdominal pain that gets worse when you move. […] Other signs and symptoms may include: A tender, bloated belly, Chills, Fever, Trouble peeing, Trouble passing gas or pooping, Vomiting, Thirst, Confusion, Fast heart rate, Shortness of breath, Easy bruising, Swollen legs and feet (edema). […] If you get peritoneal dialysis, symptoms also may include: Cloudy dialysis fluid, White flecks, strands, or clumps in the dialysis fluid.

• #3 Peritonitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/peritonitis.html

  Peritonitis can be a serious, deadly disease. […] Each persons symptoms may vary. They may include: Severe belly pain that gets worse with any motion, Nausea and vomiting, Fever, Sore or swollen belly, Fluid in the belly, Not being able to have a bowel movement or pass gas, Less urine than normal, Thirst, Trouble breathing, Low blood pressure and shock. […] Peritonitis can lead to serious health problems. It can be deadly if not treated right away. […] Peritonitis can cause severe health problems. It can be deadly if not treated right away. […] Peritonitis can make fluid fill up in your belly. This can cause severe fluid loss or dehydration. […] If peritonitis isnt treated, the infection can quickly spread through your body. This can cause an extreme response from your infection-fighting system (immune system) called sepsis. […] Severe sepsis can cause your body to go into shock. It can lead to organ failure and death.

• #3 Spontaneous Bacterial Peritonitis(Archived) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448208/

  There is a short window of opportunity for treating SBP before it progresses to septic shock or multisystem organ failure; therefore, rapid assessment and diagnosis are critical (i.e., treatment is much more successful if antibiotics are started before the development of shock). […] The infection-related mortality in SBP is very low with appropriate treatment. However, the mortality rate is quite high in those patients who develop sepsis. But with appropriate antibiotic therapy, better outcomes can be achieved. In hospital settings, the non-infection-related mortality in SBP patients can be as high as 20-40 percent, and one to two years of mortality rates are 70 and 80 percent, respectively. […] Spontaneous bacterial peritonitis carries a mortality rate of 30 to 70% in patients with end-stage liver and kidney disease. The mortality rates are lower in children with nephrosis. Recently the mortality rates have shown a slight decrease because of earlier diagnosis and advances in treatment. For the patient who develops septic shock secondary to bacterial peritonitis, the mortality increases each hour until antibiotic therapy is started.

• #3 Spontaneous bacterial peritonitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/793

  Spontaneous bacterial peritonitis (SBP) is one of the most frequently encountered bacterial infections in patients with cirrhosis, and most commonly seen in patients with end-stage liver disease. […] Key symptoms are abdominal pain, fever, vomiting, altered mental status, and gastrointestinal (GI) bleeding. However, patients are commonly minimally symptomatic, and may even be asymptomatic. […] SBP is diagnosed by an ascitic fluid absolute neutrophil count 250 cells/mm, in the absence of an intra-abdominal surgically treatable source of infection. Positive blood cultures confirm the diagnosis. […] Albumin is indicated in the treatment of patients with SBP; particularly for those with kidney dysfunction. […] Continuous antibiotic prophylaxis is indicated in patients with a previous episode of SBP, upper GI bleeding, or in patients with an ascitic fluid protein concentration 15g/L (1.5 g/dL) plus evidence of severe liver failure (Child-Pugh score 9 points with serum bilirubin 51.31 micromol/L [3 mg/dL]) and/or renal dysfunction (serum creatinine 106 micromol/L [1.2 mg/dL], urea 8.92 mmol/L [25 mg/dL], or serum sodium 130 mmol/L [130 mEq/L]). […] Key diagnostic factors include abdominal pain or tenderness, fever, nausea/vomiting, altered mental status, and gastrointestinal bleed.

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