Peritonitis history and symptoms
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Overview
The main manifestations of peritonitis are acute abdominal pain, tenderness, and guarding, which are exacerbated by moving the peritoneum, e.g. coughing, flexing the hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits pain, but releasing the hand abruptly will aggravate the pain, as the peritoneum snaps back into place).
Abdominal pain & tenderness: The localisation of these manifestations depends on whether peritonitis is localised (e.g. appendicitis or diverticulitis before perforation), or generalised to the whole abdomen; even in the latter case, pain typically starts at the site of the causing disease. Peritonitis is an example of acute abdomen.
Collateral manifestations
- Diffuse abdominal rigidity ("washboard abdomen") is often present, especially in generalised peritonitis;
- Fever;
- Sinus tachycardia;
- Development of ileus paralyticus (i.e. intestinal paralysis), which also causes nausea and vomiting;