首先要对急性腹膜炎的概念有清晰认识。强调详尽、准确地采集病史和全面细致的物理检查是诊断的基石，避免过度依赖特殊诊疗设备。从是否为外科急腹症、病变性质、病变部位几个方面理清思路，层层深入，辅以必要的特殊检查手段，尽量作出准确诊断。

Diagnostic thinking of acute diffuse peritonitis LI Zhan-liang. The First Affiliated Hospital, General Hospital of PLA, Beijing100037,China Abstract The importance of having a good command of present illness and comprehensive physical examination is emphasized. The sequence of diagnostic thinking is to confirm acute abdomen, to find out the nature and the source of peritonitis.