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, INTESTINES, BILE DUCTS, BLADDER, and other hollow organs such as GASTRIC ULCER, TYPHOID FEVER, GALL-STONES, rupture of the bladder, strangulated HERNIA, and obstructions of the bowels, may lead to peritonitis. Numerous bacteria may cause the inflammation, the 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. Urgent hospital admission is required. X-ray or ultrasound examination may show gas in the peritoneal cavity. Treatment consists of intravenous fluids, antibiotics and surgical repair of the causative condition.