It is difficult to diagnose<unk> . It is hard to distinguish between<unk>  and secondary peritonitis as there is usually a continuum between the two. It is hard to attain the exact point in which secondary peritonitis becomes<unk>  and so it is often missed clinically. The diagnosis of<unk>  should be timely and preferably before laparotomy to help reduce the risk of complications. This will improve the outcome of the condition. Diagnosis of<unk>  is firstly supported by clinical signs e.g. fever, hypotension. Surgically, it is diagnosed by a second operation i.e. emergency laparotomy. This is known as a “relaparotomy”. In<unk> , there is no anatomical defect in the lining of the peritoneum and so a planned or an emergency laparotomy after the initial treatment is the most common way to diagnose<unk> . At present, there is no evidence in the effectiveness of specific clinical or laboratory parameters or scoring systems in place to specifically help aid and guide the diagnosis of<unk>  but in an ICU consensus conference, three parameters where suggested to help in the diagnosis of<unk> . The clinical parameters include the Mannheim Peritonitis Index and the Simplified Acute Physiology Score II (SAPS II) and the laboratory parameters include the C-reactive protein test. These parameters can only help identify those patients who may develop future<unk> , if they are performed early. It is important to note that these parameters are not definite assessments of<unk>  and so have limited clinical value. Definition<unk>  can be defined as the persistence or recurrence of intra-abdominal infection with multiple organ failure and a systemic inflammatory response, following adequate therapy of primary or secondary peritonitis. This definition also has to encompass two crucial components which include the time period, which is 48hours, and there must be successful surgical source control. Source control refers to the physical actions taken to eliminate a focus of infection and contamination by microbes. This is achieved by drainage of the area, removal of infected tissue and measures used during the initial surgery to restore function of the area.<unk>  is a frequent complication of intra-abdominal infection in those patients who have been admitted to intensive care units and it is a hospital-acquired infection.<unk>  differs from secondary peritonitis due to the difference in microbial flora which is present and due to the lack of response to appropriate surgical treatment and antibiotics given.
Tertiary peritonitis
Spontaneous bacterial peritonitis
Culture-bound syndrome
Abdominal compartment syndrome
Feline infectious peritonitis
Hemolytic–uremic syndrome
Proteus syndrome
Postcholecystectomy syndrome