Abdominal pain and tenderness

The aim of this topic is to review the pathogenesis and clinical presentation of peritonitis, highlighting several diseases in which peritoneal involvement is commonly seen.

Learning objectives

At the completion of this topic you should be able to:

1. Describe the anatomy and physiology of the peritoneum, including the innervation of the visceral and parietal layers.
2. Discuss conditions predisposing to spontaneous bacterial peritonitis.
3. Outline intra-abdominal lesions that may be complicated by bacterial peritonitis.
4. Outline the causes of chemical peritonitis.
5. Compare the clinical features of localised and generalised peritonitis. In particular, discuss the haemodynamic consequences of generalised peritonitis.
6. Discuss the pathogenesis and clinical features of intra-abdominal abscesses. Outline the role of imaging in the management of such abscesses.
7. Outline the factors predisposing to the development of diverticular disease, emphasising the role of diet. Describe the clinical presentation and complications of diverticular disease.
8. Discuss the differential diagnosis of right iliac fossa pain. Describe the clinical presentation and complications of acute appendicitis.

1. Briefly outline the pathogenesis and complications of acute appendicitis.
2. Discuss the pathophysiology of shock caused by bacterial peritonitis.

Other relevant protocols - 15, 50

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