Peritoneum Anatomy and Conditions Affecting it
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The Peritoneum

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 20 Dec 2014 - 16:31.

Similar to the lungs, which has a covering called pleura, meninges for the brain and spinal cord, peritoneum covers the intestines, abdomen and the pelvis.

Anatomy: The peritoneum is a thin membrane that lines the abdominal and pelvic cavities, and covers most abdominal viscera (organs). The peritoneum is composed of a layer of mesothelium and a thin layer of connective tissue supports it. Though the peritoneum is almost a continuous sheet we normally differentiate into two distinct types of layers namely the Parietal peritoneum and the Visceral peritoneum.

As the names imply, the parietal peritoneum is the portion that lines the abdominal and the pelvic cavities (also known as peritoneal cavities) where as the visceral peritoneum covers the external surfaces of most of the organs in the abdomen including the entire intestinal tract.

The intestines in essence are suspended from the back portion of the peritoneal cavity by a fused double layer of parietal peritoneum, which is commonly termed as the mesentery. In some cases the parietal and the visceral peritoneum are continuous along the front portion of the abdomen which is termed as ventral mesentery.

Some organs in the abdominal cavity are not covered by the peritoneum. Kidneys, which protrude into the abdominal cavity, are not encased in visceral peritoneum and are hence known as retroperitoneal organs.

The peritoneum covering certain organs is named as per the organ it encases, namely the peritoneum covering the stomach is called mesogastrium, the one covering the jejunum (upper part of the intestines) is known as mesojejunum and the peritoneum covering the uterus is called the mesometrium.

The mesentery serves as a conduit for the blood vessels, nerves and lymphatic vessels going to and from the organ in question. The peritoneum covering the stomach is called the omentum which extends on both sides of the stomach converging into large double layered sheets which is filled with prominent patches of fat giving the shape of a lace. The stomach has two curvatures called the lesser and the greater curvatures.

The omentum coming from the lesser curvature is called the lesser omentum and extends to the liver. The peritoneum that comes from the greater curvature of the stomach is called the greater omentum and lies over the intestines and continues as a large sheet to form the parietal peritoneum.

All most all the organs in the abdomen and pelvis are encased with the peritoneum. It is not necessary to remember different types of the peritoneum and the different names it derives as it covers various organs. However, a brief understanding about peritoneum as detailed above will give an idea about an important condition affecting the peritoneum.

Conditions affecting peritoneum:

The most common condition affecting the peritoneum, which is often encountered, is called Peritonitis.Peritonitis literally means inflammation of the Peritoneum. Inflammation of the peritoneum is almost always due to some infection directly or through any infection involving any organ in the abdomen and/or pelvis. Peritonitis can occur with or without a perforation. If it occurs with or due to a perforation somewhere in the peritoneum, it is called perforated peritonitis. Perforated peritonitis is a dangerous life-threatening condition that can kill a patient within hours if a proper diagnosis is not made and an immediate attempt for treatment often through surgical procedure are not begun on a war footing.

Several conditions affecting the organs in the abdomen and pelvis might lead to peritonitis. The most common conditions that might lead to peritonitis with or without perforation are perforated peptic ulcer, severe appendicitis which may burst if not operated immediately, ectopic pregnancy in females (pregnancy taking place in the fallopian tubes), intestinal obstructions whether due to congenital conditions like Hirshprungs disease, or acquired conditions like volvulus or wormolith, a bunch of worms leading to obstruction) strangulated Inguinal hernia, twisted ovarian cyst and any pelvis inflammatory disease etc.

The list is endless and only the commonly encountered problems are mentioned. Of all the infections causing peritonitis tuberculosis is the most common mode of infection leading to Tubercular peritonitis a condition which can be cured if the person adheres strictly to the Dos and Dont’s and takes regular treatment with antitubercular drugs.

If there is accumulation of fluid as in tuberculous ascitis one may need paracentesis (removal of fluid with the help of a needle) along with regular antitubercular regime. Treatment depends on the cause and must be done on a war footing, which is always through surgical procedures done in well-equipped Institutions under expert surgeons in the respective field.

There is one procedure often performed which needs a special mention and this procedure is called Peritoneal Dialysis. This procedure is performed in cases with renal failure and is considered as an alternative life saving procedure in place of renal dialysis. In this procedure the large area of the peritoneum with rich supply of blood acts as a permeable filter and serves to filter all toxins from entering the circulation. 




*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.