Inflammation of the peritoneum, the membrane that lines the abdomen and encloses the abdominal organs. Peritonitis is not an independent disorder, but a complication of various abdominal conditions. It can be caused by bacteria, by infection or perforation of various abdominal organs, and by chemical irritation. Causes can include appendicitis, salpingitis or ectopic pregnancy, pancreatitis, perforation of the stomach, cholecystitis, or inflammation of the large intestine (diverticulitis, ulcerative colitis). Regardless of the cause peritonitis has distinctive symptoms, the most important of which is pain, localized if the inflammation is limited or throughout the abdomen if the condition is more general. Pain increases on coughing, or on application of pressure, and on release of pressure it radiates to the affected area (release pain). In severe cases any movement is painful. Pressure on the abdomen causes spastic contraction of the abdominal muscles. Internal examination can also be painful. Inhibition of intestinal peristalsis causes intes-

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