Inﬂammation of the PERITONEUM. It may be acute or chronic, localised or generally diﬀused, and its severity and danger may vary according to the cause.
Acute peritonitis generally arises because bacteria enter the peritoneal cavity, from penetrating wounds, e.g. stabs, from the exterior or from the abdominal organs. Hence conditions leading to perforation of the STOMACH, INTESTINE, BILE DUCT, URINARY BLADDER, and other hollow organs such as gastric ulcer (see STOMACH, DISEASES OF), typhoid fever (see ENTERIC FEVER), gall-stones (see under GALLBLADDER, DISEASES OF), rupture of the bladder, strangulated HERNIA, and obstructions of the bowels, may lead to peritonitis. Numerous bacteria may cause the inﬂammation, most common being E. coli, streptococci and the gonococcus.
The symptoms usually begin with a RIGOR together with fever, vomiting, severe abdominal pain and tenderness. Shock develops and the abdominal wall becomes rigid. If untreated the patient usually dies. Urgent hospital admission is required. X-ray examination may show gas in the peritoneal cavity. Treatment consists of intravenous ﬂuids, antibiotics and surgical repair of the causative condition. Such treatment, together with strong analgesics is usually successful if started soon enough.