Abstract
Nontraumatic abdominal wall and peritoneal emergencies comprise a spectrum of conditions ranging from those that are self-limiting and managed conservatively, to others which are potentially life-threatening and require immediate, multi-specialty levels of care and intervention. Imaging, particularly computed tomography (CT), plays an essential role in the care of patients with a suspected nontraumatic abdominal wall or peritoneal emergency. Nontraumatic emergencies of the abdominal wall include complications associated with hernias, abdominal wall fluid collections, and soft-tissue necrotizing infections (fasciitis), fistulas from the gut to the abdominal wall, rectus sheath hematomas, and complications associated with indwelling medical devices or catheters. Nontraumatic peritoneal emergencies include peritonitis, hemoperitoneum, pneumoperitoneum, peritoneal carcinomatosis, epiploic appendagitis, omental infarction, mesenteric adenitis, and mesenteric panniculitis. The emergency radiologist must be familiar with the imaging appearance of the abdominal wall and peritoneal emergencies, to help guide clinical management of these patients by establishing a diagnosis and identifying any potential complications.
References
Matalon SA, Askari R, Gates JD, Patel K, Sodickson AD, Khurana B. Don’t forget the abdominal wall: imaging spectrum of abdominal wall injuries after nonpenetrating trauma. Radiographics. 2017;
Ballard DH, Mazaheri P, Oppenheimer DC, Lubner MG, Menias CO, Pickhardt PJ, et al. Imaging of abdominal wall masses, masslike lesions, and diffuse processes. Radiographics. 2020;
Aguirre DA, Santosa AC, Casola G, Sirlin CB. Abdominal wall hernias: imaging features, complications, and diagnostic pitfalls at multi-detector row CT. In: Radiographics; 2005.
Mirvis SE, Soto JA, Shanmuganathan K, Yu JKW. Problem solving in emergency radiology. Philadelphia: Elsevier; 2014. p. 428–31.
Macari M, Megibow A. Imaging of suspected acute small bowel obstruction. Semin Roentgenol. 2001;
Hayeri MR, Ziai P, Shehata ML, Teytelboym OM, Huang BK. Soft-tissue infections and their imaging mimics: from cellulitis to necrotizing fasciitis. Radiographics. 2016;
Gossios K, Zikou A, Vazakas P, Passas G, Glantzouni A, Glantzounis G, et al. Value of CT after laparoscopic repair of postsurgical ventral hernia. Abdom Imaging. 2003;
Lacour M, Ridereau Zins C, Casa C, Venara A, Cartier V, Yahya S, et al. CT findings of complications after abdominal wall repair with prosthetic mesh. Diagn Interv Imaging. 2017;
Tonolini M, Magistrelli P. Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI. Insight Imaging. 2017;
Rakic S, Leblanc KA. The radiologic appearance of prosthetic materials used in hernia repair and a recommended classification. Am J Roentgenol. 2013;
Gavlin A, Kierans AS, Chen J, Song C, Guniganti P, Mazzariol FS. Imaging and treatment of complications of abdominal and pelvic mesh repair. Radiographics. 2020;
Childers BJ, Potyondy LD, Nachreiner R, Rogers FR, Childers ER, Oberg KC, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg. 2002;
Ballard DH, Mazaheri P, Raptis CA, Lubner MG, Menias CO, Pickhardt PJ, et al. Fournier gangrene in men and women: appearance on CT, ultrasound, and MRI and what the surgeon wants to know. Can Assoc Radiol J. 2020;
Fukuda T, Sakamoto I, Kohzaki S, Uetani M, Mori M, Fujimoto T, et al. Spontaneous rectus sheath hematomas: clinical and radiological features. Abdom Imaging. 1996;
Rimola J, Perendreu J, Falcó J, Fortuño JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. AJR Am J Roentgenol. 2007;
Brittenden J, Tolan DM. Radiology of the post surgical abdomen. Radiol Post Surg Abdom. 2013;
Carr CM, Jacob J, Park SJ, Karon BL, Williamson EE, Araoz PA. CT of left ventricular assist devices. Radiographics. 2010;
Levy AD, Shaw JC, Sobin LH. From the archives of the AFIP: secondary tumors and tumorlike lesions of the peritoneal cavity: Imaging features with pathologic correlation. Radiographics. 2009;
Jolles HCC. CT of ascites: differential diagnosis. Am J Roentgenol. 1980;135(2):315–22.
Rudralingam V, Footitt C, Layton B. Ascites matters. Ultrasound. 2017;
Patlas MN, Alabousi A, Scaglione M, Romano L, Soto JA. Cross-sectional imaging of nontraumatic peritoneal and mesenteric emergencies. Can Assoc Radiol J. 2013;
Elsayes KM, Staveteig PT, Narra VR, Leyendecker JR, Lewis JS, Brown JJ. MRI of the peritoneum: spectrum of abnormalities. Am J Roentgenol. 2006;
Wallace AN, McConathy J, Menias CO, Bhalla S, Wippold FJ. Imaging evaluation of CSF shunts. Am J Roentgenol. 2014;
Furlan A, Fakhran S, Federle MP. Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. Am J Roentgenol. 2009;
Gayer G, Hertz M, Manor H, Strauss S, Klinowski E, Zissin R. Dense ascites: CT manifestations and clinical implications. Emerg Radiol. 2004;
Orwig D, Federle MP. Localized clotted blood as evidence of visceral trauma on CT: the sentinel clot sign. Am J Roentgenol. 1989;
Federle MP, Pan KT, Pealer KM. CT criteria for differentiating abdominal hemorrhage: anticoagulation or aortic aneurysm rupture? Am J Roentgenol. 2007;
Lucey BC, Varghese JC, Anderson SW, Soto JA. Spontaneous hemoperitoneum: a bloody mess. Emerg Radiol. 2007;
Lubner M, Menias C, Rucker C, Bhalla S, Peterson CM, Wang L, et al. Blood in the belly: CT findings of hemoperitoneum. Radiographics. 2007;
Hertzberg BS, Kliewer MA, Paulson EK. Ovarian cyst rupture causing hemoperitoneum: Imaging features and the potential for misdiagnosis. Abdom Imaging. 1999;
Casillas VJ, Amendola MA, Gascue A, Pinnar N, Levi JU, Perez JM. Imaging of nontraumatic hemorrhagic hepatic lesions. Radiographics. 2000;
Gayer G, Jonas T, Apter S, Amitai M, Shabtai M, Hertz M. Postoperative pneumoperitoneum as detected by CT: prevalence, duration, and relevant factors affecting its possible significance. Abdom Imaging. 2000;
Borofsky S, Taffel M, Khati N, Zeman R, Hill M. The emergency room diagnosis of gastrointestinal tract perforation: the role of CT. Emerg Radiol. 2015;
Le O. Patterns of peritoneal spread of tumor in the abdomen and pelvis. World J Radiol. 2013;
Gore RM, Silvers RI, Thakrar KH, Wenzke DR, Mehta UK, Newmark GM, et al. Bowel obstruction. Radiol Clin N Am. 2015;
Neyman EG, Georgiades CS, Fishman EK. Abdominal involvement in tuberculosis. Emerg Radiol. 2002;
Singh AK, Gervais DA, Hahn PF, Sagar P, Mueller PR, Novelline RA. Acute epiploic appendagitis and its mimics. Radiographics. 2005;
Van Breda Vriesman AC, Mol D, van Otterloo AJC, Puylaert JBCM. Epiploic appendagitis and omental infarction. Eur J Surg. 2001;
Kamaya A, Federle MP, Desser TS. Imaging manifestations of abdominal Fat necrosis and its mimics. Radiographics. 2011;
Macari M, Hines J, Balthazar E, Megibow A. Mesenteric adenitis: CT diagnosis of primary versus secondary causes, incidence, and clinical significance in pediatric and adult patients. Am J Roentgenol. 2002;
Lucey BC, Stuhlfaut JW, Soto JA. Mesenteric lymph nodes seen at imaging: causes and significance. Radiographics. 2005;
McLaughlin PD, Filippone A, Maher MM. The “misty mesentery”: mesenteric panniculitis and its mimics. Am J Roentgenol. 2013;
Gögebakan Ö, Albrecht T, Osterhoff MA, Reimann A. Is mesenteric panniculitis truely a paraneoplastic phenomenon? A matched pair analysis. Eur J Radiol. 2013;
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Rajput, M.Z., Ballard, D.H. (2021). Imaging of Nontraumatic Abdominal Wall and Peritoneal Emergencies. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-44092-3_33-1
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