Learning objectives
To review the normal anatomy of the peritoneum and mesentery;
To describe the clinical characteristics and illustrate the CT appearances of tumors and tumor-like lesions that primarily and secondarily involve the peritoneum and mesentery,
with focus on common differential diagnosis.
Background
The peritoneum and mesentery can both be affected by a wide range of pathologic conditions,
including inflammatory/ infectious diseases,
benign tumor-like processes and primary and secondary neoplasms.
The diagnosis of mesenteric and peritoneal masses can be challenging since the imaging patterns of primary neoplasms,
secondary malignancies and benign processes are often non-specific.
Radiologists must become familiar with the normal anatomy and commonest pathologic processes affecting these structures so that an accurate imaging diagnosis can be reached.
Findings and procedure details
Anatomy
The peritoneum is a thin serosal membrane that lines both the inner surface of the peritoneal cavity (parietal peritoneum) and the abdominopelvic organs (visceral peritoneum).
It is composed by a single layer of mesothelial cells supported by connective tissue.
Itsmain functions are to provide a frictionless,
lubricated surface over which the viscera can move,act as local bacterial defense as well as to serve as a site of fluid transport.
The potential space between the parietal and visceral peritoneum is called peritoneal cavity.
Peritoneal ligaments,...
Conclusion
Peritoneal and mesenteric diseases represent a very diverse group,
with varying clinical presentations,
imaging appearances and prognosis.
While secondary peritoneal disease is much more common than primary etiologies,
differentiating primary from secondary causes,
remains important to guide treatment.
Peritoneal and mesenteric diseases often present with non-specific and overlapping imaging features,
but radiologists should become familiar with classic imaging appearances that may be helpful in distinguish benign from malignant processes and primary from secondary peritoneal involvement.
With a greater understanding of the anatomy,
as well as...
References
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Kaza,
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Al-Hawary,
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and Francis,
I.
(2014).
Primary and secondary disease of the peritoneum and mesentery: review of anatomy and imaging features.Abdominal Imaging,
40(3),
pp.626-642.
McLaughlin,
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