Classifications

The first classification of peritonitis was suggested by Miculich (1886): 1) septic, 2) purulent, 3) progressive fibrinopurulent, 4) local. In 1912 Grekov defined the phases of peritonitis: early (1–2 days), late (3–5 days), final (6–21 days).

Modern classification of acute peritonitis

(Shalimov A. A., 1981)

According to origin

1. Рrimary. It occurs in the absence of an apparent intra-abdominal source of infection and is observed almost exclusively in patients with ascites formation.

2. Secondary. The common aetiologic entities of secondary peritonitis include: esophagus Boerhaave’s syndrome (spontaneous rapture), malignancy, trauma, iatrogenic, peptic ulcer perforation, cholecystitis, acute pancreatitis, bowel perforation, ischaemic bowel, strangulated hernia, bowel obstruction, diverticulitis, ulcerative colitis and Crohn’s disease, appendicitis.

According to aetiology

1. Microflora of the digestive tract (E. coli, Enterococcus, Pseudomonas, Proteus, Streptococcus, Staphylococcus, Anaerobic infection).

2. Microflora non-connected with the digestive tract (tuberculous infection, gonococcal infection).

3. Aseptic (pancreatogenic, bilious).

4. Carcinomatous.

5. Parasitogenic.

According to cause

1. Traumatic.

2. Postoperative.

3. Inflammatory.

4. Perforated.

According to character of exudate

1. Serous.

2. Serofibrinous.

3. Fibrinous.

4. Fibrinopurulent.

5. Purulent.

6. Putrefactive.

According to spreading of infection

1. Local (inflammatory process is localized only in 1 anatomy region).

2. Diffuse (inflammatory process is localized in 2–5 anatomy regions).

3. Total (inflammatory process is localized in 6–9 anatomy regions).

Phases of peritonitis

1. Reactive (< 24 hours).

2. Toxic (24–72 hours).

3. Terminal (>72 hours).