Peritonitis may result in shock because?

• A. Fluid shifts from the bloodstream into body tissues
• B. Intra-abdominal hemorrhage is typically present
• C. Severe pain causes systemic dilation of the vasculature
• D. Abdominal distention impairs cardiac contractions

Answer: (A)

The main idea here is that inflammation from peritonitis causes fluids to move out of the blood vessels into body tissues and the peritoneal cavity (third spacing). This loss of intravascular volume reduces the amount of blood returning to the heart, lowers preload, and can lead to shock due to inadequate tissue perfusion. While sepsis from peritonitis can also involve vasodilation, the immediate mechanism behind shock is the fluid shift out of the bloodstream caused by the inflammatory response and increased capillary permeability. The other scenarios aren’t the primary mechanism: hemorrhage would imply blood loss, severe pain–driven vasodilation isn’t the direct cause here, and abdominal distention doesn’t directly impair cardiac contractions.