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.