In general, peritoneal thickening is most often caused by abdominal trauma, peritonitis, or metastatic malignancy. Prompt evaluation with contrast-enhanced abdominal CT or PET-CT is essential to establish the exact aetiology; treatment may then include drugs, radiotherapy, chemotherapy, or surgery.
- Abdominal trauma
A direct blow can produce local oedema or haematoma that widens the peritoneal stripe. After imaging to define the extent, small haematomas are managed conservatively, but a full-thickness peritoneal tear requires surgical repair. - Peritonitis
Bacterial infection, hollow-viscus perforation, or intraperitoneal bleeding can incite marked peritoneal inflammation and subsequent thickening, classically presenting with nausea, vomiting and abdominal pain. Intravenous antibiotics (e.g. ceftriaxone, cefoperazone–sulbactam) are given to control sepsis; laparoscopic lavage or definitive repair is undertaken when indicated. - Malignant peritoneal metastasis
Advanced gastric, colonic or ovarian cancers may seed the peritoneum, producing plaque-like thickening. Curative resection is seldom possible; cytoreductive surgery is considered only after a good response to systemic chemotherapy or palliative radiotherapy.
Patients should adopt a light, easily digested diet, avoid cold, greasy or irritating foods, and ensure adequate rest and warmth while the diagnostic and therapeutic plan is completed.
| Cause | Mechanism / Key Points | Diagnostic Note | Treatment & Nursing |
|---|---|---|---|
| Abdominal trauma | Direct blow → local oedema / haematoma → peritoneal stripe widens | CT to size haematoma / detect tear | Small: conservative; Peritoneal tear: surgical repair |
| Peritonitis | Bacterial infection, perforation, intraperitoneal bleed → inflammation & thickening; presents with nausea, vomiting, abdominal pain | CT ± paracentesis; sepsis work-up | IV antibiotics (ceftriaxone, cefoperazone-sulbactam); laparoscopic lavage / repair if needed |
| Malignant metastasis | Gastric, colonic, ovarian etc. seeds peritoneum → plaque-like thickening | CT + tumour markers; PET-CT for extent | Systemic chemotherapy ± palliative RT; cytoreductive surgery only if good response |
| General supportive care | — | — | Light, easily digested diet; avoid cold, greasy foods; adequate rest & warmth |