Peritonitis: definition

The definition of peritonitis is simple. It corresponds to an inflammation of the peritoneum (thin membrane present in the abdomen which surrounds the digestive organs). This inflammation is usually infectious.

Depending on the severity, there are two forms of peritonitis:

  • localized (or local) peritonitis: only a defined area of ​​the peritoneum is inflamed,
  • generalized (or diffuse) peritonitis: inflammation has spread throughout the abdominal cavity.

To further define what peritonitis is, a classification makes it possible to establish its origin and its evolution.

Classification of peritonitis

In about 95% of cases, peritonitis is the consequence of an infection, most often by bacteria. Depending on how the bacteria have entered the abdomen, there are different forms of peritonitis:

  • primary or primary peritonitis (also called: spontaneous or idiopathic peritonitis),
  • secondary peritonitis,
  • Tertiary peritonitis.

Primary peritonitis:

Primary peritonitis is rather rare and mainly affects children. We speak of primary peritonitis when no disease that could cause inflammation of the peritoneum is detected in the abdomen, in fact we do not find any specific cause (this is why we speak of spontaneous peritonitis or idiopathic). Bacteria are likely to enter the abdominal cavity via the blood or lymphatic circulation.

A particular form of primary peritonitis is spontaneous bacterial peritonitis that can be caused by ascites following cirrhosis of the liver (liver cirrhosis).

Secondary peritonitis:

Secondary peritonitis is by far the most common form of peritonitis. Most often it is caused by the perforation of a small part of the stomach or intestinal wall following an illness, such as appendicitis. Bacteria from the infected organ spread into the abdominal cavity, thereby transmitting inflammation to the peritoneum.

But peritonitis does not necessarily have internal origins: lesions coming from the outside - for example by stabbing - can also cause the introduction of bacteria into the abdomen and, consequently, inflammation of the abdomen. abdominal cavity.

Postoperative peritonitis is also part of so-called secondary peritonitis. As the name suggests, peritonitis occurs after surgery, for example, when the scar breaks after an intestinal operation.

Tertiary peritonitis:

Tertiary peritonitis is called when peritonitis persists and evolves. It can develop in people with immunodeficiency, such as HIV infection, immunosuppression (immune system inhibition), or in the presence of serious concomitant disease.

In very rare cases, peritonitis does not result from infection, but inflammation and irritation of the peritoneum are caused by toxic chemicals, such as bile, urine or radiological contrast media. which are introduced into the abdominal cavity after the injury of an organ.

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