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To Review The Imaging Anatomy of Peritoneal Spaces: Poster No.: Congress: Type: Authors: Keywords: Doi
To Review The Imaging Anatomy of Peritoneal Spaces: Poster No.: Congress: Type: Authors: Keywords: Doi
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Learning objectives
Background
Basic anatomy:
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Basic embryology:
The peritoneum can be broadly divided into the supra and infra colic compartments by the
transverse colon. The various subdivisions in each compartment is depicted in a simple
chart (Fig. 3).
Supracolic compartment:
The various ligaments, organs and spaces of the supra colic compartment are depicted
in the axial section of the upper abdomen (Fig. 4, 5).
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Infracolic compartment:
Transverse mesocolon form the superior boundary of the infracolic compartment and
also the posterior border of the lesser sac. It contains the middle colic vessels (Fig. 10).
The Infracolic compartment is divided into right and left compartments by Small bowel
mesentery which contains the superior mesenteric vessels (Fig. 11).
NB: The cecum is usually Retroperitoneal and hence -Retrocecal space Fluid would
generally mean appendicitis /diverticulitis (Fig. 12).
These are depicted in the axial CT images of the pelvis (Fig. 13, 14).
NB: The peritoneum is continuous male pelvis and discontinuous in women at the Ostia
of the oviducts.
Flow of Ascites:
The Flow of ascitic fluid and most common sites of malignant seeding in the peritoneum /
areas of fluid stasis (in the watershed regions) are depicted in the following diagram
(Fig.15).
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Fig. 1: Sagittal CT section demonstrating the peritoneal coverings.
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Fig. 2: Cross section of 10 week fetus and adult at the upper abdomen demonstrating
the development of peritoneal spaces.
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Fig. 3: Divisions of the peritoneal spaces.
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Fig. 4: Axial CT sections of the Supracolic compartment.
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Fig. 5: Axial CT of the Supracolic compartment depicting the various ligaments.
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Fig. 6: Bare area of the liver- sagittal CT and pictorial representation.
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Fig. 7: Sagittal CT section- greater omentum; Coronal CT section- lesser omentum.
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Fig. 8: The lesser sac- diagrammatic representation of 4 month foetus and adult (sagittal
view); Sagittal CT depicting fluid filled lesser sac in a patient with pancreatitis.
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Fig. 9: Axial and coronal CT sections of the same patient as in figure 8.
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Fig. 10: Axial and coronal Ct sections- infracolic compartment.
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Fig. 11: Coronal CT section- small bowel mesentery dividing the infracolic compartment
to right and left sides.
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Fig. 12: Axial CT sections demonstrating the paracolic gutters and retrocecal space.
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Fig. 13: Axial CT section demonstrating the pelvic ligaments in a patient with free fluid.
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Fig. 14: Axial CT section of the pelvis demonstrating the umbilical ligaments.
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Fig. 15: Pictorial depiction of the path for flow of ascites and free fluid in the peritoneum.
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Imaging findings OR Procedure details
Cross sectional imaging is the main stay in evaluating disease processes involving the
peritoneum.
Conclusion
References
Personal Information
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