If a patient develops peritoneal irritation, it is recommended that he or she be treated aggressively with surgery, as the presence of peritoneal irritation is a sign of disease progression of the primary disease and most often requires surgical treatment. However, surgical treatment requires an assessment of the patient’s overall status, vital signs, and whether the primary disease is amenable to surgical treatment. If peritoneal irritation is present, surgery is indicated, as it can be life-threatening if the risk of surgery is high. In some cases, the peritoneal irritation sign can be observed with medication to clarify the outcome of the treatment, and if the disease is getting better with conservative treatment, surgery is not necessary. If the disease is getting better with conservative treatment, surgery is not needed. Of course, if peritoneal irritation sign appears, the treatment method still suggests active surgical treatment.