Primary peritonitis in children.

Abstract

BACKGROUND: Primary peritonitis is a rare cause of the acute abdomen in children. It is often found at laparotomy for suspected appendicitis, or diagnosed by paracentesis in a child with an associated medical disorder. METHODS: Our experience over the past 5 ++years with this condition at the Royal Children's Hospital is reviewed and compared with a larger series previously published from the same institution 25 years ago. RESULTS: There were 26 cases from 1989 to 1994; 22 (85%) were female and 6 (23%) of the patients had a major underlying medical disorder. CONCLUSIONS: The incidence of primary peritonitis has remained unchanged at this institution since 1970 (4.7 cases per year), but neonatal primary peritonitis is no longer seen. Primary peritonitis is more common in females in whom there is no clear aetiology, but is presumed to be related to the retrograde passage of organisms through the genital tract. By contrast, in males primary peritonitis is rare but may be related to underlying medical conditions such as alpha-1-antitrypsin deficiency and renal disease.