Peritoneography: Normal and Pathologic Anatomy

Abstract

Plain film identification of intraperitoneal structures is generally limited to those aspects outlined by contrasting extraperitoneal fat or naturally occurring intraluminal gas. The demonstration of abdominal masses by gastrointestinal series and barium enema examination requires mucosal alterations or bowel displacement. These routine contrast studies of the intestinal tract permit visualization of its internal mucosal contour alone. An outstanding limitation is the inability to accurately evaluate the thickness of the bowel wall. Only indirect signs must be relied upon for the radiologic diagnosis of mural or serosal disease. The classic radiologic differential diagnosis between mucosal, submucosal (intramural), and extrinsic lesions is a distinction made on indirect signs only, based upon the contours of a defect. Terminology includes such descriptions as “mural defect”, yet the actual wall of the structure studied is rarely visualized radiologically.