Peritonitis causes

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Peritonitis Main Page

Patient Information




Spontaneous Bacterial Peritonitis
Secondary Peritonitis

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2] Shivani Chaparala M.B.B.S [3]


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

Causes of Infected Peritonitis

Perforation of a hollow viscus organ Disruption of the peritoneum Spontaneous bacterial peritonitis (SBP) Systemic infections
Perforation of a hollow viscus (most common cause of peritonitis)

Other possible causes for perforation

Most common organisms -mixed bacteria

Most common organisms

Peritonitis occurring in the absence of an obvious source of contamination. It occurs either in children, or in patients with ascites.

e.g. Tuberculosis

Causes of Non-Infected Peritonitis

Leakage of sterile body fluids into the peritoneum Sterile abdominal surgery Rarer non-infectious causes
Sterile body fluids such as

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)

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


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