Primary peritonitis in adults: is it time to look for a better diagnostic classification?

The occurrence of primary peritonitis is rare. The experience of a single institution and the definition of this disease are reviewed.

A retrospective audit of primary peritonitis at a single institution was undertaken. Age, sex, clinical presentation, initial diagnosis, imaging and blood tests, comorbidities, recent medical intervention, surgical treatment and operative findings, antibiosis, bacterial isolates, the course of hospital treatment and follow up, including later diagnoses, were reviewed.

The audit was carried out at Christchurch Hospital between January 1998 and March 2005. A total of 115 patients were identified with a diagnosis of non-specific peritonitis, of which five patients were identified with a diagnosis of primary peritonitis. All were women aged 22-38 years. Three had undergone a caesarean section in the last 3 months. The details of these cases are presented in detail.

Five cases of primary peritonitis are reported, and from a review of published work, a classification of primary peritonitis is suggested, which more clearly identifies the cause of the disease.