What might signify the presence of peritonitis in a patient?

The presence of peritonitis is often indicated by a rigid abdomen and guarding. Rigid abdomen refers to abdominal rigidity, where the muscles become stiff and tense, while guarding is a protective mechanism where a patient instinctively tightens their abdominal muscles in response to pain or the expectation of pain during examination. This combination is a classic sign of peritoneal irritation, which may occur due to conditions such as appendicitis, perforated viscera, or other forms of intra-abdominal inflammation.

While other signs may suggest abdominal issues, they do not specifically indicate peritonitis. For instance, a positive Murphy's sign can indicate gallbladder disease or inflammation, and decreased sensitivity of bowel sounds can point to conditions such as bowel obstruction or ileus. Bloating and gas pains are more related to gastrointestinal motility issues and do not directly correlate with the serious condition of peritonitis. Therefore, the combination of a rigid abdomen and guarding is a more specific and significant finding for identifying peritonitis.