May occur primarily, known as primary peritonitis, or as a result of trauma. surgery or soilage by bowel contents or chemical irritation.

Generally associated with abdominal pain, nausea, vomiting, possibly diarrhea and ileus.

Patients usually experience fever.

Clinical examination reveals diffuse abdominal tenderness, decreased bowel sounds, and findings of peritoneal inflammation with rebound tenderness and involuntary abdominal muscle guarding.

In the presence of ascites clinical findings may be more subtle.

Spontaneous or primary peritonitis occurs principally among individuals with ascites associated with chronic liver disease or the nephrotic syndrome.

May result from bacterial invasion or chemical irritation.

Common causes: sterile peritonitis from leakage of bile or pancreatic enzymes, perforation or rupture of the biliary system, acute hemorrhagic pancreatitis, with leakage of pancreatic enzymes and digestion of adipose tissue to produce fatty acids, with chalky white precipitates in areas of fat digestion and necrosis, following surgical procedures with introduction of foreign material such as talc, and endometriosis with leakage of blood into the peritoneum, and rupture of dermoid cysts.

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