【Abstract】ObjectiveTo evaluate the main CT features, the morbidity of CT signs and the anatomic-pathologic bases of secondary pyogenic peritonitis (SPP).
MethodsTwentyfour patients of the SPP were retrospectively studied. Emphasis was placed on the spiral CT manifestations of the SPP correlating with their anatomic-pathologic bases and the occurrence as well as the signs of primary lesions which resulted in the SPP.
ResultsThe main CT manifestations of SPP revealed as follows: the thickened peritoneum, 16 in 24 cases (66.7%), of which 14 cases were smooth and 2 cases were irregular; the ascites, 15 in 24 cases (62.5%); the free air within peritoneal cavity, 9 in 24 cases (37.5%); the edema and thickening involved in the greater omentum, 8 in 24 cases (33.3%); the small bowel mesentery, 5 in 24 cases (20.8%); and the bowels’ wall, 5 in 24 cases (20.8%); the adhesions of bowels, 6 in 24 cases (25.0%). The CT manifestation of the promary lesions, which caused SPP, and the complications were shown as follows: the signs of primary lesion, 13 cases (54.2%); the inflammatory changes in retroperitoneal cavity 13 cases (54.2%); the involvements of chest 13 cases (54.2%); and the abscess in peritoneal and pelvic cavity 6 cases (25.0%).
ConclusionThe main significant CT signs of SPP could be concluded as follows: thickened peritoneum, ascites, free air within peritoneal cavity, edematous and thickened greater omentum, the small bowel mesentery, and the bowels’ wall, as well as the adhesions of bowels. So, the CT scan can present plenty of CT signs, which are significant and very helpful for making an appropriate diagnosis of SPP.
Citation：
LU Chunyan,MIN Pengqiu,LIU Rongbo,WU Bing,ZHU Jie,DONG Peng,YAO Jin.. CT Features and Anatomic-Pathologic Bases of Secondary Pyogenic Peritonitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(1): 116-119下转124. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 1. Mayers MA. Dynamic radiology of the abdomen: normal and pathologic anatomy [M]. 5th ed. New York： SpringerVerlag, 2000∶61-67.
- 2. Min PQ, Yang ZG, Lei QF, et al. Peritoneal reflections of left perihepatic region: radiologicanatomic study [Ｊ]. Radiology, 1992; 182(2)∶553.
- 3. Molmenti EP, Balfe DM, Kanterman RY, et al. Anatomy of the retroperitoneum: observations of the distribution of pathologic fluid collections [Ｊ]. Radiology, 1996; 200(1)∶95.
- 4. Thornton FJ, Kandiah SS, Monkhouse WS, et al. Helical CT evaluation of the perirenal space and its boundaries: a cadaveric study [Ｊ]. Radiology, 2001; 218(3)∶659.
- 5. Rodriguez E, Pombo F. Peritoneal tuberculosis versus peritoneal carcinomatosis: distinction based on CT findings [Ｊ]. J Comput Assist Tomogr, 1996; 20(2)∶269.
- 6. Krumenacker JH, Panicek DM, Ginsberg MS, et al. CT in searching for abscess after abdominal or pelvic surgery in patie6nts with neoplasia: do abdomen and pelvis both need to be scanned? [Ｊ]. J Comput Assist Tomogr, 1997; 21(4)∶652.
- 7. McDowell RK, Dawson SL. Evaluation of the abdomen in sepsis of unknown origin [Ｊ]. Radiol Clin North Am, 1996; 34(1)∶177.
- 8. Gore RM, Miller FH, Pereles FS, et al. Helical CT in the evaluation of the acute abdomen [Ｊ]. AJR Am J Roentgenol, 2000; 174(4)∶901.
- 9. 薛雁山, 纪智, 刘秀梅. 结核性腹膜炎的CT表现 [Ｊ]. 中华放射学杂志, 2000； 34(5)∶349.
- 10. Ha HK, Jung JI, Lee MS, et al. CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis [Ｊ]. AJR Am J Roentgenol, 1996; 167(3)∶743.
- 11. Jadvar H, Mindelzun RE, Olcott EW, et al. Still the great mimicker: abdominal tuberculosis [Ｊ]. AJR Am J Roentgenol, 1997; 168(6)∶1455.
