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I would like to thank the authors for a comprehensive and well written state of the are review. Some questions, however, remain unanswered. Firstly, how was the gender distribution in the selected studies?
Secondly, if women were included, was the distribution of the causes of peritonitis different in men and women? Why did all your anatomical figures exclude the internal female genitals.
Finally, did the authors consider describing not only clinical findings, laboratory tests and imaging modalities, but also the diagnostic and therapeutic processes involving at least two clinical specialities, surgery and gynaecology?
In my own working experience from both abdominal/general surgery and gynaecology, female patients have experienced delays in diagnosis and treatment, and the state of the art review could be a powerful tool to address and avoid such delays.