Peritoneal Disease

The peritoneum is the thin membrane that lines the abdominal cavity and covers the abdominal organs. It can be affected by infection, inflammation, scarring and by tumours that either start in the peritoneum or spread to it. Selected patients with peritoneal tumours benefit from specialised surgery combined with systemic treatment, planned by a multidisciplinary team.

Peritoneal metastases

What it is: A condition in which cancer cells spread to the lining of the abdominal cavity, most often from colorectal, appendiceal, gastric or ovarian cancer.

Symptoms: Abdominal swelling from fluid (ascites), bloating, loss of appetite, bowel obstruction or weight loss; early disease may be silent.

Treatment: Systemic chemotherapy for most patients. In carefully selected cases with limited disease, cytoreductive surgery with or without HIPEC (heated intraperitoneal chemotherapy) may offer long-term control.

Pseudomyxoma peritonei

What it is: A rare mucus-producing tumour, usually originating from the appendix, that gradually fills the abdomen with jelly-like material.

Symptoms: Progressive abdominal distension, a hernia or a mass, sometimes found during surgery for suspected appendicitis.

Treatment: Complete cytoreductive surgery with HIPEC in a specialised centre offers the best results.

Peritoneal mesothelioma

What it is: A rare cancer arising from the cells that line the peritoneum, sometimes linked to asbestos exposure.

Symptoms: Abdominal pain, swelling, ascites and weight loss.

Treatment: Treatment is individualised and may include cytoreductive surgery with HIPEC in selected patients, and systemic therapy.

Primary peritoneal cancer

What it is: A cancer that starts in the peritoneum itself and is closely related to ovarian cancer in behaviour and treatment.

Symptoms: Abdominal swelling, bloating, pain and change in bowel habit.

Treatment: Combination of surgery and chemotherapy, coordinated with gynaecological oncology.

Peritonitis

What it is: Inflammation of the peritoneum, most often caused by infection from a perforated organ such as the appendix, a diverticulum or an ulcer.

Symptoms: Severe abdominal pain, tenderness, fever, rapid heart rate and feeling very unwell.

Treatment: A medical and surgical emergency: fluid resuscitation, antibiotics and, in most cases, surgery to treat the source of infection.

Intra-abdominal abscess

What it is: A localised collection of pus inside the abdomen, which may follow appendicitis, diverticulitis or previous surgery.

Symptoms: Fever, localised abdominal pain and generally feeling unwell.

Treatment: Antibiotics with image-guided drainage in most cases; surgery is reserved for abscesses that cannot be drained percutaneously.

Adhesions and adhesive bowel obstruction

What it is: Adhesions are bands of scar tissue that form between abdominal organs, usually after previous surgery or inflammation, and can kink or obstruct the bowel.

Symptoms: Colicky abdominal pain, distension, vomiting and inability to pass gas or stool; some patients have chronic discomfort.

Treatment: Many obstructions settle with bowel rest and a nasogastric tube. Surgery, laparoscopic when possible, is needed if obstruction does not resolve or there are signs of compromised bowel.

How assessment is organized

Assessment includes clinical examination, blood tests and tumour markers, and imaging with CT, MRI or PET-CT. For peritoneal tumours, the extent of disease is carefully evaluated, sometimes with diagnostic laparoscopy, before deciding whether surgery is appropriate. Decisions are made within a multidisciplinary team.

This information is general and does not replace individual medical assessment.