K65 Peritonitis

Name of the Condition

• Common name(s): Peritonitis
• Medical term: Peritonitis

Summary

Peritonitis is an inflammation of the peritoneum, the thin tissue lining the inner wall of the abdomen and covering most abdominal organs. This condition often results from infection, injury, or other irritants that trigger an inflammatory response within the peritoneal cavity. It can be localized or generalized and may require prompt medical attention to prevent complications.

Causes

Peritonitis typically arises from bacterial or fungal infections, which may enter the peritoneal cavity through a perforated organ (e.g., appendix, stomach, or intestine), abdominal trauma, or post-surgical complications. Non-infectious causes include chemical irritation from bile, pancreatic enzymes, or blood, as well as inflammatory conditions like pancreatitis or diverticulitis.

Risk Factors

• Recent abdominal surgery or procedures
• Perforated abdominal organs (e.g., appendicitis, peptic ulcer)
• Liver disease (e.g., cirrhosis) or ascites
• Compromised immune system
• Long-term peritoneal dialysis
• Abdominal trauma or injury

Symptoms

• Severe, persistent abdominal pain that worsens with movement
• Abdominal tenderness or rigidity
• Fever and chills
• Nausea, vomiting, or loss of appetite
• Bloating or distension
• Rapid heart rate or breathing
• Fatigue or weakness

Diagnosis

Diagnosis involves a physical exam to assess abdominal tenderness, rigidity, or guarding. Imaging studies (e.g., CT scan, ultrasound) may identify fluid, abscesses, or perforations. Blood tests can detect signs of infection (elevated white blood cell count) or organ dysfunction. In some cases, peritoneal fluid analysis or laparoscopy may be used to confirm the cause.

Treatment Options

• Antibiotic or antifungal therapy to target the underlying infection
• Surgical intervention to repair perforations, drain abscesses, or remove infected tissue
• Supportive care, including intravenous fluids, pain management, and nutritional support
• Peritoneal dialysis adjustments (if applicable)

Prognosis and Follow-Up

Prognosis depends on the cause, severity, and timeliness of treatment. Early intervention improves outcomes, but severe or untreated cases can lead to sepsis or organ failure. Follow-up care may include monitoring for recurrence, imaging to assess healing, and adjustments to treatment plans based on clinical response.

Complications

• Sepsis or septic shock
• Organ failure (e.g., kidney, liver)
• Abdominal abscess formation
• Adhesions or bowel obstruction
• Chronic peritoneal scarring

Lifestyle & Prevention

• Prompt treatment of abdominal infections or injuries
• Adherence to post-surgical care instructions
• Management of underlying conditions (e.g., liver disease, diabetes)
• Hygiene practices for peritoneal dialysis patients
• Avoidance of unnecessary abdominal trauma

When to Seek Professional Help

Seek immediate medical attention for severe abdominal pain, fever, vomiting, or signs of shock (e.g., rapid heart rate, confusion). Delayed treatment can worsen outcomes.

Tips for Medical Coders

Document the underlying cause (e.g., perforated appendix, post-surgical infection) and specify if the peritonitis is localized or generalized. Include details on diagnostic methods (e.g., imaging, fluid analysis) and treatment approaches (e.g., surgery, antibiotics) to support accurate code assignment. Ensure documentation aligns with clinical findings to reflect the severity and etiology of the condition.