Benign Diseases of the Peritoneum and Retroperitoneum

The peritoneum and retroperitoneum, once considered just spaces, are now recognized as primary locations for trauma, inflammation, infection, benign neoplasms, and malignancies. To understand the spread of disease in these locations, one must first understand their anatomy, physiology, and relationship. As both the peritoneum and retroperitoneum contain multiple organs, the relationships of the abdominal organs within these spaces are critical. This review defines both the peritoneum and retroperitoneum and then describes the most common disease states and spread of disease within these spaces. Spread of disease, in particular, spread of malignancy, within the peritoneum is complex but predictable and can be treated in certain instances with heated intra-abdominal chemotherapy intraoperatively. This review contains 5 figures, 5 tables, and 37 references. Key words: ascites, carcinomatosis, desmoid, hyperthermic intra-abdominal chemotherapy, peritoneum, peritonitis, retroperitoneal sarcoma, retroperitoneum

Benign Diseases of the Peritoneum and Retroperitoneum

The peritoneum and retroperitoneum, once considered just spaces, are now recognized as primary locations for trauma, inflammation, infection, benign neoplasms, and malignancies. To understand the spread of disease in these locations, one must first understand their anatomy, physiology, and relationship. As both the peritoneum and retroperitoneum contain multiple organs, the relationships of the abdominal organs within these spaces are critical. This review defines both the peritoneum and retroperitoneum and then describes the most common disease states and spread of disease within these spaces. Spread of disease, in particular, spread of malignancy, within the peritoneum is complex but predictable and can be treated in certain instances with heated intra-abdominal chemotherapy intraoperatively. This review contains 5 figures, 5 tables, and 37 references. Key words: ascites, carcinomatosis, desmoid, hyperthermic intra-abdominal chemotherapy, peritoneum, peritonitis, retroperitoneal sarcoma, retroperitoneum

Hypothyroidism with Ascites

Primary hypothyroidism is a common clinical condition. Ascites caused by hypothyroidism is rare. So its diagnosis is often delayed and patients frequently receive unnecessary procedures such as liver biopsies and exploratory laparotomies. We report a male person of 58 years with hypothyroidism with ascites who responded well with thyroid hormone replacement therapy with complete resolution of ascites. Analyses of ascites from patients in this condition usually shows exudative ascites with high protein (>2.5 g/dL) and SAAG < 1.1 gm/dl. High index of suspicion is required to reach at such diagnosis. Though it is a rare but prognosis is excellent with replacement therapy. Key words: Ascites, Hypothyroidism. doi: 10.3329/jom.v10i2.2828 J MEDICINE 2009; 10 : 121-123