Peritonitis causes: Difference between revisions

	Peritonitis Main Page
Patient Information
Overview
Causes
Classification Spontaneous Bacterial Peritonitis Secondary Peritonitis
Differential Diagnosis

VisualWikitext

Revision as of 20:38, 1 November 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

The most common cause of peritonitis is perforation of a hollow viscus such as perforation of the distal esophagus (Boerhaave syndrome), of the stomach (peptic ulcer, gastric carcinoma), of the duodenum (peptic ulcer), of the remaining intestine (e.g. appendicitis, diverticulitis, Meckel's diverticulum, IBD, intestinal infarction, intestinal strangulation, colorectal carcinoma, meconium peritonitis), or of the gallbladder (cholecystitis). Other causes of infected peritonitis include spontaneous bacterial peritonitis and disruption of the peritoneum, such as in cases of trauma, surgical wounds, continuous peritoneal dialysis, and intra-peritoneal chemotherapy. Causes of non-infected peritonitis include endometriosis, blunt abdominal trauma, gastric carcinoma, peptic ulcer, pelvic trauma, and pancreatitis.

Causes

Causes of peritonitis can be divided into infected and non-infected, which are as follows:

Infected peritonitis causes

Perforation of a hollow viscus	Disruption of the peritoneum	Spontaneous bacterial peritonitis (SBP)	Systemic infections
Perforation of a hollow viscus (most common cause of peritonitis) -perforation of the distal esophagus (Boerhaave syndrome) -perforation of the stomach (peptic ulcer, Gastric carcinoma) -perforation of the duodenum (peptic ulcer) -perforations of the remaining intestine (e.g. Appendicitis, Diverticulitis, Meckel diverticulum, IBD, Intestinal infarction, Intestinal strangulation, Colorectal carcinoma, Meconium peritonitis) -perforation of the gallbladder (cholecystitis) Other possible causes for perforation -Trauma, -Ingestion of a sharp foreign body (such as a fish bone) -perforation by an endoscope or catheter Most common organisms -mixed bacteria -Gram-negative bacilli (e.g. Escherichia coli), Anaerobic bacteria (e.g. Bacteroides fragilis)	-Trauma -surgical wound -peritoneal dialysis -chemotherapy Most common organisms -mixed bacteria Staphylococcus aureus, Coagulase-negative staphylococci, Fungi such as Candida	peritonitis occurring in the absence of an obvious source of contamination. It occurs either in children, or in patients with ascites.	e.g- Tuberculosis

Non-infected peritonitis causes

Leakage of sterile body fluids into the peritoneum	Sterile abdominal surgery	Rarer non-infectious causes
Sterile body fluids such as -Blood(e.g.Endometriosis, Blunt abdominal trauma), Gastric juice (e.g.Peptic ulcer, Gastric carcinoma), Bile (e.g. Liver biopsy), Urine (e.g. Pelvic trauma), Menstruum (e.g. salpingitis), Pancreatic juice (pancreatitis), These body fluids are sterile at first, they frequently become infected once they leak out of their organ, leading to infectious peritonitis within 24-48h.	Due to sterile foreign body inadvertently left in the abdomen after surgery (e.g. gauze,sponge)	Familial Mediterranean fever, porphyria, systemic lupus erythematosus

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Appendicitis, Ascites, Boerhaave syndrome, Cholecystitis, Cholelithiasis, Chronic liver disease, Diverticulitis, Gall bladder rupture, Gastrointestinal perforation, IBD, Intestinal strangulation, Mallory-Weiss syndrome, Meckel diverticulitis, Meconium peritonitis, Neonatal necrotizing enterocolitis, Pancreatitis, Peptic ulcer, Perihepatitis, Recurrent hereditary polyserositis, Toxic megacolon, Typhlitis
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Continuous ambulatory peritoneal dialysis, Intra-peritoneal chemotherapy, Surgical wounds
Infectious Disease	Bacteroides fragilis, E. coli, Enterobacteriaceae, Escherichia coli, Fitz-Hugh Curtis syndrome, Klebsiella pneumoniae, Pseudomonas, Staphylococcus, Streptococcus pneumoniae, Streptococcus pyogenes, Miliary tuberculosis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	Endometriosis, Fitz-Hugh Curtis syndrome, Pelvic inflammatory disease
Oncologic	Colorectal carcinoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Nephritic syndrome
Rheumatology/Immunology/Allergy	Systemic lupus erythematosus,
Sexual	No underlying causes
Trauma	Trauma
Urologic	No underlying causes
Miscellaneous	Ruptured dermoid cyst, Spontaneous bacterial peritonitis

Causes in Alphabetical Order

3

References

Template:WikiDoc Sources

@@ Line 81: / Line 81: @@
 |}
-===Infected peritonitis===
-* Perforation of a hollow viscus is the most common cause of peritonitis. Examples include perforation of the distal [[esophagus]] ([[Boerhaave syndrome]]), of the [[stomach]] ([[peptic ulcer]], [[gastric carcinoma]], of the [[duodenum]] ([[peptic ulcer]]), of the remaining [[intestine]] (e.g. [[appendicitis]], [[diverticulitis]], [[Meckel diverticulum]], [[IBD]], intestinal infarction, intestinal strangulation, [[colorectal carcinoma]], [[meconium peritonitis]]), or of the [[gallbladder]] ([[cholecystitis]]). Other possible reasons for perforation include [[physical trauma|trauma]], ingestion of a sharp [[foreign body]] (such as a fish bone), perforation by an [[endoscope]] or [[catheter]], and anastomotic leakage. The latter occurrence is particularly difficult to diagnose early, as [[abdominal pain]] and [[ileus|ileus paralyticus]] are considered normal in patients who just underwent [[abdominal surgery]]. In most cases of perforation of a hollow viscus, mixed [[bacteria]] are isolated; the most common agents include [[gram-negative]] [[bacilli]] (e.g. ''[[Escherichia coli]]'') and [[anaerobic bacteria]] (e.g. ''[[Bacteroides fragilis]]'').
-* Disruption of the [[peritoneum]], even in the absence of perforation of a hollow viscus, may also cause infection simply by letting [[micro-organisms]] into the peritoneal cavity. Examples include [[physical trauma|trauma]], surgical wound, continuous ambulatory [[peritoneal dialysis]], and intra-peritoneal [[chemotherapy]]. Again, in most cases mixed [[bacteria]] are isolated; the most common agents include cutaneous species such as ''[[Staphylococcus aureus]]'', and [[coagulase]]-negative [[staphylococci]], but many others are possible, including [[fungi]] such as [[Candida]].
-* Spontaneous bacterial peritonitis (SBP) is a peculiar form of peritonitis occurring in the absence of an obvious source of contamination. It occurs either in [[children]], or in patients with [[ascites]]. See the article on [[spontaneous bacterial peritonitis]] for more information.
-* Systemic infections (such as [[tuberculosis]]) may rarely have a peritoneal localization.
-===Non-infected peritonitis===
-* Leakage of [[sterilization (microbiology)|sterile]] [[body fluids]] into the peritoneum, such as [[blood]] (e.g.[[endometriosis]], blunt abdominal [[physical trauma|trauma]]), [[gastric juice]] (e.g. [[peptic ulcer]], [[gastric carcinoma]]),[[bile]] (e.g. [[liver biopsy]]), [[urine]] (pelvic [[physical trauma|trauma]]), [[menstruum]] (e.g. [[salpingitis]]), [[pancreatic juice]] ([[pancreatitis]]), or even the contents of a ruptured [[dermoid cyst]]. It is important to note that, while these [[body fluids]] are sterile at first, they frequently become infected once they leak out of their organ, leading to infectious peritonitis within 24-48h.
-* Sterile abdominal surgery normally causes localized or minimal generalized peritonitis, which may leave behind a foreign body reaction and/or fibrotic [[adhesion (medicine)|adhesion]]s. Obviously, peritonitis may also be caused by the rare, unfortunate case of a [[sterile technique|sterile]] [[foreign body]] inadvertently left in the [[abdomen]] after [[surgery]] (e.g. [[gauze]],[[sponge]]).
-* Much rarer non-infectious causes may include [[familial Mediterranean fever]], [[porphyria]], and [[systemic lupus erythematosus]].
 ===Causes by Organ System===