Source: Gross AW, Olsen KM, DiPiro JT. Intra-abdominal infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146072317. Accessed April 14, 2017.
Acute, inflammatory response of peritoneal lining to microorganisms, chemicals, irradiation, or foreign body injury.
Primary peritonitis: intra-abdominal focus may not be evident.
Secondary peritonitis: focal disease process evident.
Abscess: purulent collection of fluid separated from surrounding tissue by wall consisting of inflammatory cells and adjacent organs.
Table 1 summarizes many potential causes of bacterial peritonitis.
Causes of intra-abdominal abscess overlap those of peritonitis.
Primary peritonitis most commonly associated with end-stage alcoholic cirrhosis.
TABLE 1.Causes of Bacterial Peritonitis ||Download (.pdf) TABLE 1. Causes of Bacterial Peritonitis
|Primary bacterial peritonitis |
|Peritoneal dialysis |
|Cirrhosis with ascites |
|Nephrotic syndrome |
|Secondary bacterial peritonitis |
|Miscellaneous causes |
| Diverticulitis |
| Appendicitis |
| Inflammatory bowel diseases |
| Salpingitis |
| Biliary tract infections |
| Necrotizing pancreatitis |
| Neoplasms |
| Intestinal obstruction |
| Perforation |
|Mechanical GI problems |
| Any cause of small bowel obstruction (adhesions and hernia) |
|Vascular causes |
| Mesenteric arterial or venous occlusion (atrial fibrillation) |
| Mesenteric ischemia without occlusion |
| Blunt abdominal trauma with rupture of intestine |
| Penetrating abdominal trauma |
|Iatrogenic intestinal perforation (endoscopy) |
Solid organ transplant in the abdomen.
|Peritoneal contamination during abdominal operation |
|Leakage from GI anastomosis |
Forms through combined action of:
Oxygen tension low within abscess, allowing anaerobic bacteria to thrive.
TABLE 2.Pathogens Isolated from Patients with Intra-abdominal Infection