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Results for “PERITONEAL DISEASES”

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At least 19 recordsLinked to original sources
PubMed2005

Computed tomography manifestations of peritoneal diseases.

The peritoneal cavity is a potential space that is divided by the peritoneal reflections into various complex subspaces. It can be involved in many disease processes including developmental, inflammatory, neoplastic and traumatic conditions. Computed tomography is highly sensitive and consistent in detecting peritoneal pathology. This pictorial essay aims to emphasize and illustrate the CT features of the spectrum of peritoneal diseases.

Diagnosis, Differential↗
PubMed1994

MR imaging of peritoneal disease: comparison of contrast-enhanced fast multiplanar spoiled gradient-recalled and spin-echo imaging.

OBJECTIVE: We performed this study to compare contrast-enhanced fast multiplanar spoiled gradient-recalled (SPGR) MR imaging with unenhanced spin-echo imaging for the detection of benign and malignant peritoneal abnormalities. MATERIALS AND METHODS: We retrospectively reviewed abdominal MR images of 34 patients with proved peritoneal abnormalities, including 21 patients with malignant and 13 patients with benign peritoneal disease. Six additional patients had false-positive interpretations of their MR examinations because of diaphragmatic thickening and enhancement. Unenhanced T1-weighted images, fast spin-echo T2-weighted images, and breath-hold fast multiplanar SPGR images obtained immediately and 10-15 min after IV injection of gadopentetate dimeglumine were available. Images were reviewed for evidence of peritoneal disease by two observers who had no knowledge of the clinical findings. The four types of images were separately evaluated for peritoneal thickening, masses, and abnormal enhancement. The anatomic location, thickness, and pattern of thickening of the peritoneum were noted. Results were correlated with surgical findings or results of percutaneous biopsy. RESULTS: Immediate and delayed contrast-enhanced fast multiplanar SPGR images showed malignant peritoneal tumor in all 21 cases, compared with T1-weighted images, which showed tumor in 11 cases (p < .01), and fast spin-echo T2-weighted images, which showed tumor in 13 cases (p < .01). Enhancement of the peritoneal tumor increased the tumor's conspicuity, particularly on delayed fast multiplanar SPGR images, which were selected as the best sequence for detection of peritoneal tumor in 18 of the 21 cases. The MR findings varied widely from moderately and regularly thickened, enhancing peritoneum to very thick (> 1 cm) and lobular or masslike peritoneal thickening with enhancement. Delayed fast multiplanar SPGR images showed evidence of benign peritoneal disease in all 13 cases compared with immediate fast multiplanar SPGR images, which showed disease in 12 cases (p > .05); T1-weighted images, which showed disease in four cases (p < .05); and fast spin-echo T2-weighted images, which showed disease in only one case (p < .01). In the benign forms of peritoneal disease, the peritoneum was often regular in contour and tended to be thinner than in the cases of malignant peritoneal tumor, in which the peritoneum was generally thicker and more lobular or masslike. However, significant overlap was seen between the MR findings in benign and malignant forms of peritoneal disease. CONCLUSION: Detection of peritoneal abnormalities with MR imaging can be improved by using contrast-enhanced fast multiplanar SPGR imaging. The findings of peritoneal thickening and enhancement are best depicted on delayed images.

Adult↗
PubMed1988

Case-control study to determine the cause of sclerosing peritoneal disease.

This paper presents the results of a case control study based on 55 patients identified with sclerosing peritoneal disease through the 1984 centre questionnaire. For each case with a confirmed finding of small bowel enclosed in a bag or 'cocoon' of thickened peritoneum, three controls were selected from the main EDTA Registry patient file. Questionnaires were sent out on cases and controls in order to compare exposure to a number of factors implicated in the aetiology of sclerosing peritoneal disease. These included a history of peritonitis, use of agents to sterilise the tubing connection, use of bacterial filters and buffers, drugs added to the dialysate, and history of medication with beta-blockers. Questionnaires were returned for 82% of cases and 74% of controls. Analysis of the returns using McNemar's test showed a significantly higher exposure to chlorhexidine in cases compared with controls. On the basis of this strong association, it seems advisable that the use of chlorhexidine to sterilise tubing connections for peritoneal dialysis patients should be halted.

Chlorhexidine↗
PubMed2004

Targeting of HER2 antigen for the treatment of disseminated peritoneal disease.

The studies reported herein demonstrate the efficacy of alpha-particle-targeted radiation therapy of peritoneal disease with Herceptin as the targeting vehicle. Using the CHX-A-DTPA linker, Herceptin was radiolabeled with indium-111 and bismuth-213 with high efficiency without compromising immunoreactivity. A pilot radioimmunotherapy study treating mice bearing 5-day LS-174T (i.p.) xenografts, a low but uniform HER2 expressing, human colon carcinoma, with a single dose of (213)Bi-CHX-A"-Herceptin, proved disappointing. This defined the effect of tumor burden/size on tumor response to radioimmunotherapy with alpha-radiation. A more successful experiment with a lower tumor burden (3 days) in mice followed. A specific dose-response (P = 0.009) was observed, and although a maximum-tolerated dose was not determined, a dose of 500 to 750 muCi was selected as the operating dose for future experiments based on changes in animal weight. Median survival was increased from 20.5 days for the mock-treated mice to 43 and 59 days with 500 and 750 muCi, respectively. The therapeutic effectiveness of (213)Bi-CHX-A"-Herceptin was also evaluated in a second animal model for peritoneal disease with a human pancreatic carcinoma (Shaw). The results of this study were not as dramatic as with the former model, and higher doses were required to obtain an increase in survival of the mice (P = 0.001).

Animals↗
PubMed2001

Peritoneal washings are not predictive of occult peritoneal disease in patients with hilar cholangiocarcinoma.

BACKGROUND: Evaluation of peritoneal cytology provides valuable staging information in patients with gastric and pancreatic adenocarcinoma, but its usefulness in patients with extrahepatic cholangiocarcinoma is unclear. The aim of this study was to evaluate the predictive value of peritoneal cytology in patients with potentially resectable hilar cholangiocarcinoma. This study evaluated a possible association between positive peritoneal cytology and percutaneous transhepatic biliary drainage, which is commonly used in these patients and may result in peritoneal biliary leakage and peritoneal seeding. STUDY DESIGN: From October 1997 through June 2000 26 patients with hilar cholangiocarcinoma underwent staging laparoscopy immediately before planned open exploration and resection. Peritoneal washings were obtained during laparoscopic examination before any biopsies were taken. Cytologic analysis was performed using the Papanicolau technique. RESULTS: There were 18 men and 8 women, with a median age of 69 years (range 42 to 81 years). The most common presenting symptom was jaundice (n = 19). Previous biliary drainage was performed in 23 patients: 9 percutaneous and 14 endoscopic. Metastatic disease was suspected preoperatively in six patients, three to the liver, two to the peritoneum, and one to regional lymph nodes, all of which were confirmed at laparoscopy. Laparoscopy identified five additional patients with metastatic disease. Peritoneal cytology was positive for malignant cells in two patients, both of whom had gross peritoneal metastases. Nine other patients had metastatic disease to distant sites within the abdomen, but none had positive cytology. Overall, six patients had metastatic disease to the peritoneal cavity, only one of whom had undergone earlier percutaneous biliary drainage. CONCLUSIONS: Peritoneal cytology was not predictive of occult metastatic disease. Laparoscopic staging identified some patients with unresectable hilar cholangiocarcinoma, but analysis of peritoneal cytology provided no additional information. There was no association between percutaneous transhepatic biliary drainage and peritoneal tumor seeding.

Adult↗
PubMed1992

Primary papillary serous carcinoma of the peritoneum: a case of complete remission of bulky peritoneal disease after chemotherapy.

Peritoneal papillary serous carcinoma is a rare tumor that involves the surface of the pelvic and/or abdominal peritoneum. Long-term survival among patients with this tumor has been rare. Most patients with this cancer have been treated with debulking surgery and postoperative chemotherapy. A case of incompletely resected peritoneal papillary serous carcinoma with a complete response to cisplatin-based chemotherapy is reported. Subsequent laparotomy revealed no residual tumor. This case suggests that primary chemotherapy may be successful in treating unresectable primary papillary serous tumors of the peritoneum.

Aged↗
PubMed2005

Alpha-particle radioimmunotherapy of disseminated peritoneal disease using a (212)Pb-labeled radioimmunoconjugate targeting HER2.

These studies demonstrate the feasibility of targeted therapy for the treatment of disseminated peritoneal disease using (212)Pb-labeled Herceptin as an in vivo generator of (212)Bi. In vitro studies compare the potential of the bismuth radioisotopes, (213)Bi and (212)Bi, to that of (212)Pb. Overall, (212)Pb results in a higher therapeutic index than either bismuth radioisotope, requiring lower radioactivity (microCi) for effective cytotoxic response. A pilot radioimmunotherapy (RIT) experiment treating mice bearing 5 d LS-174T intraperitoneally (i.p.) xenografts determined a maximum tolerated dose (MTD) of 20-40 microCi with i.p. administration. A specific dose response was observed and 10 microCi was selected as the effective operating dose for future experiments. Median survival of tumor-bearing mice receiving 10 microCi increased from 19 to 56 days (p = 0.008). The efficacy of (212)Pb-Herceptin was also assessed in a human pancreatic carcinoma xenograft (Shaw; i.p.) animal model previously reported as unresponsive to 213Bi-Herceptin (p = 0.002). Multiple dosing of (212)Pb-Herceptin was evaluated in both animal models. The median survival of mice bearing 3 d LS-174T i.p. xenografts increased to 110 days, with up to 3 doses of (212)Pb-Herceptin given at approximately monthly intervals; however, there was no evidence of a correlation with the second and third doses (p = 0.98). No improvement in median survival was noted with a similar regimen in the Shaw xenograft model.

Alpha Particles↗
PubMed1993

[Pain during peritoneum pinching, a pathognomonic sign of peritoneal disease. Clinical research. Semiological value].

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

Adult↗
PubMed1994

Postoperative adhesive peritoneal disease. Laparoscopic treatment.

The aim of this prospective study was to judge the efficiency of laparoscopic adhesiolysis: 52 patients have been treated laparoscopically either for obstruction (group 1: 17 patients) or for chronical abdominal pain (group 2: 35 patients). Two out of five peroperative complications required a laparoconversion whereas two postoperative complications required a laparotomy for intestinal obstruction. Six patients of group 1 developed a recurrence of obstruction treated by laparoscopy in four and by laparotomy in two cases. At the time of the study (among 50 patients with a mean follow-up of 24 months), 32 patients were asymptomatic, 13 found that their symptoms had lessened, and finally, five patients were not improved. We concluded that laparoscopic adhesiolysis is an attractive surgical procedure, allowing a clinical improvement in 45 out of 50 patients in our study.

Abdominal Pain↗
PubMed1995

[Gelatinous peritoneal disease].

Gelatinous degeneration of the peritoin is an unusual disorder which inevitably takes the surgeon by surprise during laparotomy. Three cases are reported. The diagnosis, pathogenesis, prognosis and possible therapies are discussed. The tumoral pathogenesis usually appears to be non-malignant and to originate in the ovaries or appendix. However, gelatinous degeneration of the peritoin must be viewed as a disease with attenuated malignancy. The pattern of development is slow, with repeated peritoneal recurrences. The survival time is long. Treatment is essentially surgical even when recurrences occur.

Adenocarcinoma, Mucinous↗