Which medical conditions should be considered in the differential diagnoses of peritonitis and abdominal sepsis?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

According to Adler and Gasbarra, the following should be considered in the differential diagnosis [10] :

  • Chemical irritants (eg, bile, blood, gastric juice, barium, enema or douche contents)

  • Chronic peritoneal dialysis

  • Chylous peritonitis

  • Eosinophilic peritonitis

  • Familial Mediterranean fever

  • Fungal infections (eg, histoplasmosis, cryptococcosis, coccidioidomycosis)

  • Granulomatous peritonitis (eg, parasitic infestations, sarcoidosis, tumors, Crohn disease, starch granules)

  • Gynecologic disorders (Chlamydia peritonitis, salpingitis, endometriosis, teratoma, leiomyomatosis, dermoid cyst)

  • HIV-associated peritonitis (from opportunistic organisms)

  • Mesothelial hyperplasia and metaplasia

  • Neoplasms (eg, primary mesothelioma, secondary carcinomatosis, Pseudomyxoma peritonei)

  • Parasitic infections (eg, schistosomiasis, ascariasis, enterobiasis, amebiasis, strongyloidiasis)

  • Perforated viscus

  • Peritoneal encapsulation

  • Peritoneal loose bodies and peritoneal cysts

  • Peritoneal lymphangiectasis

  • Pyelonephritis

  • Sclerosing peritonitis

  • Splenosis

  • Vascular conditions (eg, mesenteric embolus, mesenteric nonocclusive ischemia, ischemic colitis, portal vein thrombosis, mesenteric vein thrombosis)

  • Vasculitis (eg, systemic lupus erythematosus, allergic vasculitis [Henoch-Schönlein purpura], Kohlmeier-Degos disease, polyarteritis nodosa)


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