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Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. [2] Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. [2] [3] One part or the entire abdomen may be tender. [1]
For the most common cause, peritoneal carcinomatosis, omental caking is associated with a wide variety of symptoms. Ascites and intestinal peristalsis is known to have an effect on how diffusely the cancer cells are spread throughout the abdomen. This wide range of presentation makes omental caking difficult to diagnose based on symptoms alone. [5]
It is thinner than the parietal peritoneum. The mesentery is a double layer of visceral peritoneum that attaches to the gastrointestinal tract. There are often blood vessels, nerves, and other structures between these layers. The space between these two layers is technically outside of the peritoneal sac, and thus not in the peritoneal cavity.
The greater omentum is the larger of the two peritoneal folds. It consists of a double sheet of peritoneum, folded on itself so that it has four layers. [2] The two layers of the greater omentum descend from the greater curvature of the stomach and the beginning of the duodenum. [2]
Bile, pus, or blood released from viscera anywhere along its length may run along the paracolic gutter, and collect in sites quite remote from the organ of origin. [2] In supine patients, infected fluid from the right iliac fossa may ascend in the paracolic gutter to enter the lesser sac.
The peritoneal sac containing omentum may be palpable between the thumb and index finger. [11] The prolapse may be detectable at the upper posterior vaginal wall during Valsalva's maneuver. [11] Imaging which may be used to detect cul-de-sac hernia includes standard defecography, magnetic resonance defecography and dynamic transperineal ...
The lesser omentum (small omentum or gastrohepatic omentum) is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into these two connecting parts: the hepatogastric ligament, and the hepatoduodenal ligament. [1]
Initial management consists of immediate blood transfusion if the patient is in hemorrhagic shock. Classically, hemoperitoneum was an indication for emergency surgery to locate the source of bleeding and also to recover spilled blood from the peritoneal cavity and to use it for auto-transfusion if it has not been contaminated by ruptured bowel contents.