Peritonitis.

Intraperitoneal infections or inflammatory disease in elderly patients are a diagnostic challenge that will be encountered with increasing frequency in the aging population of the United States. Diagnostic clues are not overt and frequently appear late in the course of the disease. Confusion and subtle changes in clinical status are important signals. A high index of suspicion is required to initiate diagnostic procedures. Therapy will frequently be modified not only to the disease process but also to the patient to incorporate concepts of minimally invasive procedures. The advent of laparoscopic surgery may be a great advance in the diagnosis and treatment of intra-abdominal crisis in geriatric patients. It also may make elective surgery conform more to the goals of the geriatric patient and thus prevent the high morbidity and mortality associated with emergency surgery in this age group.