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Acute bacterial peritonitis Acute bacterial peritonitis most commonly arises from perforation of a viscus of the alimentary tract. Other routes of infection can include the female genital tract and exoge nous contamination. Less common forms involve a prima...

Adhesions Pathology - Adhesions are best classified with reference to their appear - ance. They are subdivided into peritoneal, areolar and dense adhesions. Peritoneal (sclerotic) adhesions - These are mesothelial adhesions between two mesothelial surfaces ( Fi...

Biliary peritonitis Biliary peritonitis is mostly seen after cholecystectomy and arises from slippage of a clip o ff the cystic duct, drainage of bile from an accessory cystic duct or perforation of the common bile or hepatic duct (see Chapter 71 ). It can a...

Chronic mesenteric ischaemia Chronic mesenteric ischaemia is due to atherosclerotic narrowing at the origin of any of the three arterial trunks. Patients describe postprandial abdominal pain that can be severe, resulting in a fear of eating with progressive...

Chylous ascites In some patients, the ascitic fluid appears milky because of an excess of chylomicrons (triglycerides). Most of these cases are associated with malignancy (usually lymphoma). Other causes include cirrhosis, TB, filariasis, nephrotic syndrome, ...

DEVELOPMENT OF THE MESENTERY AND PERITONEUM Early in development, the human abdomen comprises a wall and enclosed space (coelom). A partition (mesentery) subdivides the cavity into left- and right-sided spaces ( Figure 65.1 The mesentery comprises a cell body ...

Diffuse (generalised) peritonitis This normally signifies the occurrence of a life-threatening pathology . It means that regions (not just focal areas) of the parietes (parietal peritoneum) are inflamed. It normally arises as a result of pressure-related perfo...

FURTHER READING Byrnes KG, McDermott K, Co ff ey JC (eds). Mesenteric organogenesis. Semin Cell Dev Biol 2019; 92 : 1–138. Co ff ey JC, Dockery P . Peritoneum, mesentery and peritoneal cavity . In: Standring S (ed.). Gray’s anatomy: the anatomical basis of clin...

Familial Mediterranean fever Familial Mediterranean fever (FMF; synonym familial paroxysmal polyserositis) is an autosomal recessive inherited autoinflammatory syndrome characterised by episodic di ff use abdominal pain and tenderness, mild pyrexia and joint pai...

History In ileocaecal volvulus the patient often describes a longstand ing history of intermittent, colicky abdominal pain associated with distension and vomiting. In between episodes (when the volvulus has detorted) the patient is entirely asymptomatic and r...

INTRAPERITONEAL ABSCESS FORMATION An intraperitoneal abscess is a collection of pus in the peritoneal cavity ( Figure 65.10 ). It normally arises secondary to another - pathology . Inflammation of any viscus, if unresolved, will lead to hypersecretion of pe...

Intraperitoneal collections Ascites Peritoneal fluid is constantly secreted and absorbed. Accumu lation of peritoneal fluid, termed ascites, occurs when there is excess production or reduced absorption. Production of large volumes of a protein-rich fluid occurs...

Introduction No content extracted automatically.

Investigation The modern diagnosis of an abscess is radiological using CT ( Figure 65.10 ). CT imaging can also guide treatment by drain placement or aspiration. Ultrasound is a useful (though non-specific) modality for use in select populations (e.g. paedi at...

Learning objectives To understand: The development and anatomy of the mesentery and • peritoneum

MESENTERIC ADENITIS AND THE MESENTERY IN CROHN’S DISEASE Ileocaecal mesenteric adenitis occurs in ileocolic Crohn’s disease and the mesentery is thickened, shortened and oedem atous with a tendency to bleed readily when handled. The vascular pedicles within th...

MESENTERIC ADENITIS This is inflammation of the lymph nodes of the mesentery - ( Figure 65.11 ). It mostly occurs in the ileocaecal region because of the volume of lymphatic tissue. It is often the site of viral - or infective lymphadenopathy ( Yersinia s...

MESENTERIC HAEMATOMA A mesenteric haematoma can follow abdominal compression in trauma (e.g. seat-belt syndrome) or during abdominal surgery , when the mesentery must be manipulated. The mesenteric stroma is mainly adipose and thus easily damaged. It bleeds r...