Appropriate Tests


If indicated: Peritoneal fluid examination - microscopy, culture and cytology.

Blood culture. Full blood count, Blood film, White cell count differential.

'Surgical', especially

  • Acute appendicitis
  • Perforated peptic ulcer
  • Pelvic inflammatory disease
  • Ruptured ectopic pregnancy
  • Intraperitoneal bleeding


Peritoneal dialysis


Primary infection, especially

  • Streptococcus pneumoniae in
    • Alcoholic cirrhosis
    • Nephrotic syndrome
    • Post-splenectomy
  • Mycobacterium tuberculosis


See Alcoholism, Cirrhosis

See Splenic atrophy/absence

See Tuberculosis


  • Connective tissue diseases, especially
    • SLE

Systemic/metabolic causes of abdominal pain and 'peritonism' should also be considered.

Acute intermittent porphyria

See Porphyria

Hereditary angioedema 

See C1 inhibitor deficiency

Familial Mediterranean fever

Molecular genetics.