急性弥漫性腹膜炎的病因不尽相同。原发性腹膜炎是肝硬变腹水的严重并发症，多见于有严重肝病背景的病人。继发性腹膜炎是由感染进入腹腔内所致，腹腔内脏器破裂穿孔，例如阑尾坏疽穿孔是继发性腹膜炎的常见病因。其次是胃十二指肠溃疡穿孔或胆囊炎穿孔或肝脏破裂，胃肠内容物和胆汁流入腹腔内产生化学性腹膜炎，继发感染后成为化脓性腹膜炎。第三类型腹膜炎的发病主要由肠内细菌易位引起，具有院内获得性腹腔内感染的特征。

Pathogenetic identificatian of acute diffuse peritonitis WU Xiao-ting. Department of Gastrointestional Surgery, West China Hospital, Sichuan University, Chengdu 610041, China Abstract The pathogeny of acute diffuse peritonitis is totally different. Primary peritonitis(PP) is a serious complication of cirrhotic ascites, arising most frenquently in patients with advanced liver disease. Secondary peritonitis(SP) is often caused by intra-abdominal infections, through perforation of the bowel, such as a ruptured appendix. The chemical peritonitis may also be caused by introduction of a chemically irritating material, such as gastric acid from a perforated ulcer or bile from a perforated gallbladder or a lacerated liver ,and the disease will becomes suppurative peritonitis after bacterial secondary infection. The most important pathogenic mechanism for tertiary peritonitis(TP) is enteral bacterial translocation. TP possesses characteristics of hospital acquaired complicated intra-abdominal infections.