# Peritonitis --- **Peritonitis** is a swelling of the [[peritoneum]] typically from a [[gastrointestinal tract|bowel rupture]] or [[appendicitis]]. It's pretty serious, and needs to be treated right away. The normal flora of the intestines causes a really strong infection when in the peritoneum. ## Signs & Symptoms - Acute diffuse pain that becomes localized and more intense - Tender, distended and rigid abdomen - Rebound tenderness may be present - Anorexia, N/V - Paralytic ileus - Fever, increase pulse - Elevated WBC immature neutrophils - Hgb/HCT may be low - Free Air & Fluids in abdomen X-ray ## Treatment - ICU admission - IV fIuids, colloids, electrolyte replacement - IV antibiotics, pain meds, antiemetics - Oxygenation with intubation if needed - Urgent surgery for perforated bowel - Resection and repair - Remove abscess drainage - lf caused by appendix, that would be excised - May need [[ostomy]] (fecal diversion) temporarily ___