الفهرس | Only 14 pages are availabe for public view |
Abstract The peritoneum is the largest serous membrane in the body and the most complex structure, composed of visceral’ and parietal layers which enclose large peritoneal space referred as the peritoneal cavity. Mesentery is a part of peritoneum which attaches most of abdominal organs with the abdominal wall, and the omentum which is a doubled layered extension of the peritoneum that connects the stomach to adjacent organs. The peritoneal reflections form the greater and lesser omenta, vesicouterine pouch, pararectal pouch and paravesical pouch in the pelvis. (1) The natural flow of peritoneal fluid determines the route of spread of the intraperitoneal fluid and consequently of disease processes within the abdominal cavity as the peritoneum serve both as boundaries for diseases processes and as conduits for diseases spread ,and frequently involved by infectious, inflammatory ,neoplastic ,vascular and traumatic processes. (2) The peritoneum is a common site of metastases spread for many malignancies in four ways : direct spread along the peritoneal reflections ;intraperitoneal seeding ;lymphatic extension ;and embolic haematogenous spread from ovarian cancers, gynecological causes (cervical, tubal& endometrial) ,gastric carcinoma ,colorectal cancers, appendicular, breast ,lung ,prostatic ,hepatic, renal, gastrointestinal tumors, urinary bladder tumor, and tumors of unknown origin .(3,4,5) Primary peritoneal tumors are rare as mesothelioma, papillary serous carcinoma, primary sarcoma, and liposarcoma. (6) Several methods are employed in order to narrow the differential diagnoses list of Peritoneal tumors , these include medical history ,physical examination ,ultrasound (pelviabdominal , transvaginal ),biopsy aspiration cytology, laparscope , 2-(fluorine 18) fluro-2-deoxy-d-glucose (FDG) positron emission tomography (PET scan) , MRl, CA-125assay blood test as a tumor marker, lower OIT Barium enema which is a series of X rays of the colon and rectum. |