Which of the following conditions is most likely to directly cause peritonitis?
A. Cholelithiasis
B. Gastritis
C. Perforated ulcer
D. Incarcerated hernia
Correct Answer: C. Perforated ulcer
The most common cause of peritonitis is a perforated ulcer, which can pour contaminates into the peritoneal cavity, causing inflammation and infection within the cavity. Peritonitis is most often caused by the introduction of infection into the otherwise sterile peritoneal environment through organ perforation, but it may also result from other irritants, such as foreign bodies, bile from a perforated gallbladder or a lacerated liver, or gastric acid from a perforated ulcer. The other conditions don’t by themselves cause peritonitis.
Option A: However, if cholelithiasis leads to rupture of the gallbladder, peritonitis may develop. Biliary peritonitis is caused by perforation of the gallbladder, bile duct, or upper gastrointestinal tract. Nontraumatic perforation of the bile duct is a disease in which the extrahepatic duct or intrahepatic duct is perforated spontaneously without traumatic or iatrogenic injury.
Option B: If gastritis leads to erosion of the stomach wall, peritonitis may develop. If an ulcer goes through (perforates) the stomach wall, stomach contents may spill into the abdominal cavity, resulting in inflammation and usually an infection of the lining of the abdominal cavity (peritonitis) and sudden worsening of pain. Some complications of gastritis are slow to develop.
Option D: If an incarcerated hernia leads to rupture of the intestines, peritonitis may develop. Hernias that are incarcerated may be painful or may cause obstruction if the urinary bladder, ovary, or intestines are involved. Hernias that have strangulated are generally painful and may cause nausea, vomiting, peritoneal signs, peritonitis, sepsis, or even cardiovascular collapse.
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