[Acute peritonitis as an inflammation problem]

Clinical features and morphology of circumscribed, general, and diffuse peritonitis were studied on the clinical material including 66 observations and in 320 small animals. In the reactive stage of the process because of rapidly increasing toxicity microcirculation was shown to be disturbed, immunoglobulins were fixed in basal membranes of the microvessels and peritoneum, endotheliocytes and mesotheliocytes decreased in number which facilitated marked plasmorrhagy but prevented migration of leukocytes from the vessels. The function of leukocytes and nonspecific resistance of the organism increased. Cell-mediated immune reactions appeared only by the end of the first 24 hours of the disease. In the toxic and terminal stages, severe degenerative changes developed in leukocytes, and pathological processes progressed. Some pathogenetic mechanisms of common forms of peritonitis are discussed. The authors believe that the severe course of peritonitis is associated with rapidly increasing toxicity due to the effect both of microbial toxins and disorders in the microcirculation preventing adequate supply of leukocytes into the zone of inflammation as well as with late involvement into the process of protective cell-mediated immune responses.