Diseases of the peritoneum

1. Big picture

The peritoneum is a large, highly reactive serous membrane. Its diseases usually present in one of three exam patterns:

1. Acute peritonitis → abdominal pain, guarding, sepsis → surgical emergency until proven otherwise.
2. Ascites-related peritoneal disease → fluid accumulation, infection, malignancy, tuberculosis, chylous/bloody ascites.
3. Peritoneal tumors/infiltration → peritoneal carcinomatosis, mesothelioma, lymphoma → progressive ascites, weight loss, abdominal distension.

The examiner wants a safe sequence:

Acute abdomen/peritonitis?
        ↓
ABC + sepsis management + broad-spectrum antibiotics
        ↓
CT abdomen if stable