Peritoneal metastasis is frequently observed in patients with adenocarcinomas of ovary, stomach, intestine ,gallbladder or biliary tree, pancreas, lung, ovary, and uterus. The most common ultrasonographic findings are represented by ascites, omental and mesenteric involvement, serosal and parietal peritoneal implants,with liver metastasis, and/or lymphadenopathies as accessory findings. Ultrasonography is a highly sensitive test in detecting ascites and ultrasound guided aspiration of ascites is frequently used in patients with small amount of ascites. Neoplastic involvement of the great omentum is visualized by ultrasound as “omental cake”, a uniformly thick hyposonic band-shaped structure adjacent to the anterior and lateral walls of the abdomen. The involvement of the peritoneum is visualized as peritoneal parietal and serosal implants with evidence of soft tissue mass or nodules adhering to peritoneum or as irregularity or interruption of the peritoneal line. Anechoic area in the thickened peritoneum is a specific sign indicating the diagnosis of pseudoyixoma peritonei. Liver metastasis and lymphadenopathies are present in about 38 and 24 % of patients with peritoneal carcinomatosis but they do not represent a specific sign of peritoneal involvement. Ultrasonographic findings of peritoneal metastasis highly correlate with computed thomography signs and ultrasound-guided needle biopsy of peritoneal and/or omentum masses is a higly accurate method for differential diagnosis between peritoneal metastasis or peritoneal mesotelioma. The biopsy of peritoneal and/or omental masses has been performed by using fine needle but experience exists with the use of large cutting needle, thus avoiding the necessity of exploratory surgery.
KeywordsPeritoneal Carcinomatosis Peritoneal Metastasis Malignant Ascites Ultrasonographic Finding Peritoneal Mesothelioma
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