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Abdominal pain combined with fever and elevated white blood count as well as c-reactive protein are the main features of any intra-abdominal inflammation or perforation. Since these pathologies are commonly encountered, it is of crucial importance for the primary care doctor as well as the specialist to have basic knowledge about clinical symptoms, diagnostic testing and treatment options in patients with intra-abdominal inflammation or perforation. The following article provides a short summary of the most frequent causes of abdominal pain due to inflammation or perforation.