Primary peritonitis. An unusual operative diagnosis.

Primary peritonitis, or spontaneous bacterial peritonitis, is a highly morbid and often fatal complication of cirrhosis and other conditions associated with ascites. Prompt antibiotic therapy may be lifesaving, as may early surgical intervention in patients who have signs and symptoms of an acute abdomen. During a 5-year period, 12 patients had 14 episodes of primary peritonitis diagnosed in our hospital. Three patients had exploratory laparotomy, and gram-positive organisms were obtained from peritoneal fluid in two patients. The clinical features, patho-physiology, and natural courses of these patients are presented and the current literature reviewed.