bubble_chart Overview

Primary peritonitis refers to inflammation of the peritoneum without an intra-abdominal primary source, where pathogenic bacteria invade the peritoneal cavity through the bloodstream, lymphatic vessels, intestinal wall, or female reproductive tract. Most patients are in poor general condition, with a higher incidence among those suffering from chronic nephritis and cirrhosis complicated by ascites. The main pathogens are hemolytic streptococci, pneumococci, and Escherichia coli. The primary symptom is sudden onset of acute abdominal pain, initially without a clear location but quickly spreading throughout the abdomen. The key to diagnosing this condition lies in ruling out secondary peritonitis.

bubble_chart Clinical Manifestations

1. The onset is often preceded by an upper respiratory tract infection, or occurs in conditions such as kidney disease, scarlet fever, liver cirrhosis with ascites, and immunodeficiency;
2. The main symptoms are sudden onset of acute abdominal pain, initially with an unclear location, which quickly spreads throughout the entire abdomen;
3. Accompanied by nausea, vomiting, fever, rapid pulse, and systemic toxic symptoms;
4. Abdominal distension and fullness, generalized abdominal muscle rigidity, tenderness, rebound tenderness, and diminished or absent bowel sounds.

bubble_chart Diagnosis

1. Persistent abdominal pain, initially with an unclear location, quickly spreading throughout the abdomen.
2. There are obvious signs of peritoneal irritation, and borborygmi disappear.
3. Pus is aspirated from the abdomen, which is thin and odorless, and microscopic examination of the smear reveals Gram-positive cocci.

bubble_chart Treatment Measures

1. For patients definitively diagnosed with primary peritonitis, non-surgical treatment can be adopted, including the use of antibiotics sensitive to coccal infections or broad-spectrum antibiotics to control the infection; fluid infusion and supportive therapy.
2. If non-surgical therapy proves ineffective, the condition progressively worsens, or secondary peritonitis cannot be ruled out, exploratory laparotomy should be performed.

Primary peritonitis has no obvious intra-abdominal source of infection and is caused by pathogens from the bloodstream, lymph, intestines, or fallopian tubes. It often occurs during upper respiratory tract infections and when systemic immune resistance is compromised. The diagnosis of peritonitis can be made based on abdominal pain, peritoneal irritation signs, and other clinical manifestations, but the possibility of secondary peritonitis should be excluded. Through detailed history-taking and physical examination, supplemented by laboratory tests, B-ultrasound, X-ray, and peritoneal puncture, the diagnosis can generally be established. Non-surgical treatment is initially employed, including the application of antibiotics, fluid replacement, and supportive therapy. If the response is poor and the condition progressively deteriorates, exploratory laparotomy should be performed.

bubble_chart Cure Criteria

1. Cure: Clinical symptoms and signs disappear.
2. Improvement: Clinical symptoms and signs improve.
3. No cure: Clinical symptoms and signs show no improvement.