Learning objectives
1.
Review peritoneal anatomy
2.
Review preoperative radiological assessment of peritoneal disease and PCI
3.
Review newer techniques of treating peritoneal malignancy and the role of the radiologist
Background
Peritoneal carcinomatosis is the intraperitoneal spread of tumour that does not originate from the peritoneum itself.
The finding of a peritoneal malignancy raises major therapeutic concerns and is associated with a poor prognosis.
Systemic chemotherapy regimens and palliative surgery were offered only with the aim of reducing the symptoms.
Since the 1990s ,
cytoreductive surgery (CRS) is used in the treatment of a subset of patients with peritoneal carcinomatosis.
However,
newer modalities like hyperthermic intraperitoneal chemotherapy (HIPEC) and Pressurized Intra Peritoneal Aerosol Chemotherapy (PIPAC) have...
Findings and procedure details
Peritoneal Anatomy
The peritoneum is a thin,
translucent,
serous membrane.
The parietal and visceral peritoneum are the two layers of peritoneum.
The peritoneal cavity is a potential space between the two layers.
Peritoneal ligaments are double layers or folds of peritoneum that support a structure within the peritoneal cavity; omentum and mesentery are specifically named peritoneal ligaments.
Omentum is a double layer of peritoneum that extends between the stomach and duodenal bulb to adjacent organs.
Mesentery is a double layer of peritoneum that encloses an...
Conclusion
1.
Radiology has a vital role to play in appropriate management of patients with peritoneal disease
2.
Radiologists should be aware about PCI and its relevance in treatment selection
Personal information
Dr.
Pooja Kembhavi
Dept of Radiodiagnosis,
Tata Memorial Hospital,
Mumbai,
India
[email protected].
Dr.
Anuradha Chandramohan
Dept of Radiology,
Christian Medical College and Hospital,Vellore,
Tamil Nadu,
India
[email protected]
Dr Suman Kumar
Dept of Radiodiagnosis,
Tata Memorial Hospital,
Mumbai,
India
[email protected]
Dr Delnaz Palsetia
Dept of Radiodiagnosis,
Tata Memorial Hospital,
Mumbai,
India
[email protected]
Dr Sanjeev Kumar
Dept of Surgery,
Tata Memorial Hospital,
Mumbai,
India
[email protected]
Dr Avanish Saklani
Dept of Surgery,
Tata Memorial Hospital,
Mumbai,
India
[email protected]
Dr Akshay Baheti
Dept of Radiodiagnosis,
Tata Memorial Hospital,
Mumbai,...
References
1.
Rhonda L Harmon and Paul H Sugarbaker,
Prognostic indicators in peritoneal carcinomatosis from gastrointestinal cancer,
Int Semin Surg Oncol.
2005; 2: 3.
2.
Chukwuemeka U.
Ihemelandu et al,
Management of Peritoneal Carcinomatosis from Colorectal Cancer,
Semin Oncol.
2011; 38(4): 568–575.
3.
Emily A.
Aherne et al,
What the Radiologist Should Know About Treatment of Peritoneal Malignancy, American Journal of Radiology,
March 2017,
Volume 208,
Number 3
4.Chandramohan A,
Thrower A,
Smith SA,
et al.
“PAUSE”: a method for communicating radiological extent of peritoneal malignancy....