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| | THE MERCK MANUAL, Sec. 3, Ch. 25, Acute Abdomen And Surgical Gastroenterology |
 | | Acute peritonitis is either primary--a rare disease in which the peritoneum is infected via the bloodstream--or secondary to many causes, the most common of which is perforation of the GI tract. |
 | | The most serious causes of peritonitis are perforation of a viscus into the peritoneal cavity (intra-abdominal esophagus, stomach, duodenum, bowel, appendix, colon, rectum, gallbladder or biliary tree, urinary bladder), trauma, infected intraperitoneal blood, foreign bodies, strangulating intestinal obstruction, pancreatitis, pelvic inflammatory disease (PID), and vascular catastrophes (mesenteric thrombosis or embolism). |
 | | It is a chemical peritonitis, initially with a high level of amylase in the exudate; later, contamination with organisms from the GI tract may occur. |
| www.merck.com /pubs/mmanual/section3/chapter25/25f.htm (1900 words) |
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