Peritonitis

Advanced: Rebound tenderness, board-like abdomen, vomiting, fever, obvious

Early: Persistent tenderness despite every effort to distract

• Onset nausea/vomiting after progression of pain raises suspicion

High-Risk: elderly, debilitated, compromised hosts, portal hypertension

• Peritonitis can be very subtle in these patients
• Send such patients to ER for new onset abdominal pain

See posting Abdominal Pain – 3.