Fluid Collections

  • Armando Rossi
  • Giorgio Rossi
Part of the Medical Radiology book series (MEDRAD)


Fluid collections in the peritoneal cavity and in subperitoneal spaces are usually a consequence of pathologic processes affecting intraperitoneal organs; occasionally, they may represent the extension of collections from extra- or retroperitoneal compartments. Fluids can be constituted by transudate, exudate, blood, pus, bile, lymph, urine, pancreatic fluid, mucin or food, and are produced by a variety of processes: inflammatory, vascular, traumatic, neoplastic (primary or secondary), metabolic or consequent to hepatic, renal, cardiac failure or surgery (Table 5.1).

Table 5.1.

Causes of peritoneal collection

Transudative ascites

Portal hypertension

Morgagni-Laennec atrophic cirrhosis

Congestive heart failure

Constrictive pericarditis

Inferior vena cava obstruction

Hepatic vein occlusion (Budd-Chiari syndrome)

Portal vein obstruction


Nephrotic syndrome

Malabsorption syndrome

Exudative ascites

Peritoneal carcinomatosis (due to ovarian, colic, gastric, hepatic, pancreatic, pulmonary or mammary tumors or to melanomas)




AIDS and related syndromes

Chronic renal failure

Chylous ascites

Obstruction or discontinuity of lymphatic flow: congenital, tumoral, traumatic, surgery-induced, tubercular or due to filariasis

Hematic collections


Surgical Surgical operation

Anticoagulant therapy / hemorrhagic diathesis

Spontaneous rupture of tumors rich in vessels

Spontaneous rupture of hemorrhagic and endometriotic cyst or of ectopic gestation

Bile collections

Rupture of the biliary tree due to: surgical operation, biliary drainage, transcutaneous or endoscopic cholangiography, traumas, intraluminal hypertension

Urine collections


Instrumental procedures

Intraluminal hypertension

Derivative surgical procedures


Surgical operations

Pancreatic collections

Acute pancreatitis

Endoscopic cholangiopancreatography

Surgical operations

Purulent collectionsa

Extension of visceral inflammations

Intestinal perforations

Surgical operations

see Chap. 6


Fluid Collection Ascitic Fluid Pleural Fluid Constrictive Pericarditis Malignant Ascites 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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General considerations

  1. Auh TH, Rubenstein WA, Markisz JA, Zirinsky K, Whalen JP, Kazam E (1986a) Intraperitoneal paravesical spaces: CT delineation with US correlation. RadioLogy 159:311–317PubMedGoogle Scholar
  2. Auh YH, Rubenstein WA, Schneider M, Reckler JM, Whalen JP, Kazam E (1986b) Extraperitoneal paravesical spaces: CT delineation with US correlation with US. Radiology 159:319–332PubMedGoogle Scholar
  3. Baer JW (1990) Extraperitoneal mass effect by ascites under tension. Gastrointest Radiol 15:3–8PubMedCrossRefGoogle Scholar
  4. Brindicci D, Ettorre GC, Francioso G, Angone G, Grimaldi F, Monteduro M (1990) La TC nelle asciti. Radiol Med 80:889–892PubMedGoogle Scholar
  5. Bydder GM, Kreel L (1980) Attenuation values of fluid collections within the abdomen. J Comput Assist Tomogr 4:145–150PubMedCrossRefGoogle Scholar
  6. Callen PW, Marks WM, Filly RA (1979) Computed tomography and ultrasonography in the evaluation of the retroperitoneum in patients with malignant ascites. J Comput Assist Tomogr 3:581–584PubMedCrossRefGoogle Scholar
  7. Callen PW, Filly RA, Korobkin M (1978) Ascitic fluid in the anterior paravescical fossa: misleading appearance on CT scans. AJR Am J Roentgeool 130:1176–1177Google Scholar
  8. Churchill RA, Meyers MA (1986) Intraperitoneal fluid collections. In: Meyers MA (ed) Computed tomography of the gastrointestinal tract. Spinger, New York Berlin HeidelbergGoogle Scholar
  9. Churchill RJ (1989) CT of intra-abdominal fluid collections. Radiol Clin North Am 27:653–666PubMedGoogle Scholar
  10. Cohen JM, Weinreb JC, Maravilla KR (1985) Fluid collections in the intraperitoneal and extraperitoneal spaces: comparison of MR and CE Radiology 155:705–708PubMedGoogle Scholar
  11. Cooper C, Silverman PM, Davros WJ, et al (1993) Delayed contrast enhancement of ascitic fluid on CT: frequency and significance. AJR Am J Roentgenol 161:787PubMedGoogle Scholar
  12. Di Giandomenico E, Storto ML, Dimarzo G, Delli Pizzi C, Pirronti T, Ciccotosto C, Filippone A, Bonomo L (1988) La tac nello studio delle raccolte addominali. Incontri di Radiologia 6:33–41Google Scholar
  13. Dwyer A (1978) The displaced crus: a sign for distinguishing between pleural fluid and ascites on CT. J Comput Assist Tomogr 2:598–599PubMedCrossRefGoogle Scholar
  14. Federle MP, Jeffrey RB (1983) Hemoperitoneum studied by computed tomography. Radiology 148:187–192PubMedGoogle Scholar
  15. Gore RM, Callen PW, Filly RA (1982) Lesser sac fluid in predicting the etiology of ascites. CT findings. AJR Am J Roentgenol 139: 71–74PubMedGoogle Scholar
  16. Griffin DJ, Gross BR, McCracken S, Glazer GM (1984) Observation on CT differentiation of pleural and peritooeal fluid. J Comput Assist Tomogr 8:24–28PubMedCrossRefGoogle Scholar
  17. Haaga JR (1988) The peritoneum and mesentery. In: Haaga JR, Alfidi RJ (eds) Computed tomography of the whole body, 2nd edn). Mosby, St Louis, pp 1137–1199Google Scholar
  18. Halvorsen RA, Fedyshin PJ, Korobkin M, et al (1986) Ascites or pleural effusion? CT differentiation: four useful criteria. Radiographics 6:135–149PubMedGoogle Scholar
  19. Hammerman AM, Oberle PA, Susman N (1990) Opacification of ascitic fluid on delayed contrast computed tomography scans. Clin Imaging 14:222–224CrossRefGoogle Scholar
  20. Heiken JP (1989) Abdominal wall and peritoneal cavity. In: Lee JKT, Sagel SS, Stanley RJ (eds) Computed body tomography with MRI correlation, 2nd edn). Raven Press, New York, pp 675–705Google Scholar
  21. Krauetz GW, Cho KC, Baker SR (1988) Radiologic evaluation of pancreatic ascites. Gastrointest Radiol 13:163–166CrossRefGoogle Scholar
  22. Jeffrey RB (1980) CT demonstration of peritoneal implants. AJR Am J Roentgenol 135:323–326PubMedGoogle Scholar
  23. Jeffrey RB (1983) Computed tomography of the peritoneal cavity and mesentery. In: Mossa AA, Gamsu G, Genant HK (eds) Computed tomography in the body. Saunders, PhiladephiaGoogle Scholar
  24. Jeffrey RB, Federle MP, Goodman PC (1981) Computed tomography of the lesser peritoneal sac. Radiology 141:117–122PubMedGoogle Scholar
  25. Jolles H, Coulam CM (1980) CT of ascites: differential diagnosis. AJR Am J Roentgenol 135:315–322PubMedGoogle Scholar
  26. Levi C, Gray JE, McCullough EC, Hattery RR (1982) The unreliability of CT numbers as absolute values. AJR Am J Roentgenol 139:443–447PubMedGoogle Scholar
  27. Louis O, Bollaert A, Osteaux M, Grivegnee A (1983) CT of peritoneal effusion and their anatomic topography. J Belge Radiol 66:107–112PubMedGoogle Scholar
  28. Meyers MA (1988) Dynamic radiology of the abdomen. Normal and pathologic anatomy. Springer, New York Berlin HeidelbergGoogle Scholar
  29. Meyers MA (1992) Radiologia dinamica dell’addome. Verduci, RomeGoogle Scholar
  30. Minutoli A, Volta S, Gaeta M (1990) Delayed enhancement of ascites following high dose contrast CT for liver metastases. J Comput Assist Tomogr 13:916–917CrossRefGoogle Scholar
  31. Naidich DP, Megibow AJ, Ross CR, et al (1983) Computed tomography of the diaphragm: peridiaphragmatic fluid localization. J Comput Assist Tomogr 7:663–640Google Scholar
  32. Osteaux M, Louis O, Darras T, et al (1985) La cavité pentonéale. In: Vasile N (ed) Tomodensitométrie corps entier. Vigot, Paris, pp 323–332Google Scholar
  33. Pandolfo I, Gaeta M, Scrivano E, et al (1989) Mediastinal pseudotumor due to passage of ascitea through the esophageal hiatus. Gastrointest Radiol 14:209–211PubMedCrossRefGoogle Scholar
  34. Parienty RA, Pradel J, Picard JD, et al (1981) Visibility and thickening of the renal fascia on computed tomograms. Radiology 139:119–124PubMedGoogle Scholar
  35. Proto AV, Lane EJ, Marangola JP (1976) A new concept of ascitic fluid distribution. AJR Am J Roentgenol 126:974–980PubMedGoogle Scholar
  36. Rabal B, Hall JT, Jackson H (1985) CT diagnosis of fluid on lesser sac mimicking thrombosis of inferior vena cava. J Comput Assist Tomogr 9:956–958CrossRefGoogle Scholar
  37. Raval B, Lakmi N (1987) CT demonstration of preferential routes of the spread of pelvic disease. Crit Rev Diagn Imaging 27:17–48PubMedGoogle Scholar
  38. Rubenstein WA, Auh VH, Whalen JP, Kazam E (1983) The perihepatic spaces: computed tomographic and ultrasound imaging. J Radiol 149:231–239Google Scholar
  39. Rust RJ, Kopecky KK, Holden RW (1984) The triangle sign: a CT sign of intrapenitoneal fluid. Gastrointest Radiol 9:107–113PubMedCrossRefGoogle Scholar
  40. Seltzer SE (1987) Analysis of the tethered bowel sign on abdominal CT as a predictor of malignant ascites. Gastrointestinal Radiol 12:245–249CrossRefGoogle Scholar
  41. Teplick JG, Teplick SK, Goodman LR, Haskin ME (1982) Interface sign: a CT sign for distinguishing pleural and intraabdominal fluid. Radiology 144:359–362PubMedGoogle Scholar
  42. Vibhakar SD, Bellon EM (1984) The bare area of the spleen: a constant CT feature of the ascitic abdomen. AJR Am J Roentgenol 142:953–955PubMedGoogle Scholar
  43. Wojtowicz L, Rzymski K, Czarneck R (1982) A CT evaluation of intraperitoneal fluid distribution. Rofo Fortschr Geb Roentgenstr Bildgeb Verfahr 137:95–99CrossRefGoogle Scholar

Hematic Collections

  1. Alexander ES, Clark RA (1982) Computed tomography in the diagnosis of abdominal hemorrhage. JAMA 248:1104–1107PubMedCrossRefGoogle Scholar
  2. Chintapalli K, Dodds WJ, Olson DL (1988) Computed tomography characteristics of intermesenteric hematomas. Comput Tomogr 12:122–128Google Scholar
  3. Federle MP, Jeffrey RB (1983) Hemoperitoneum studied by computed tomography. Radiology 148:187–192PubMedGoogle Scholar
  4. Haaga JR (1988) The peritoneum and mesentery. In: Haaga JR. Alfidi RJ (eds) Computed tomography of the whole body, 2nd edn. Mosby, St Louis, pp 1137–1199Google Scholar
  5. Heiken JP (1989) Abdominal wall and peritoneal cavityin. Iee JKT, Sagel SS, Stanley RJ (eds) Compoted body tomography with MRi correlation, 2nd edn. Raven Press, New York, Pp 675–705Google Scholar
  6. Hidaka H, Irie H, Hirata H, Shigematsu A, Matsukuma K, Tatsuma T, Era S (1990) Mesenteric hematoma; a pediatric case. Rinsho Hoshasen 35:525–528PubMedGoogle Scholar
  7. Jeffrey RB Jr, Cardoza JD, Olcott EW (1991) Detention of active intraabdominal arterial hemorrhage: value of dynamic contrast-enhanced CT. AJR Am J Roentgenol 156:725–729PubMedGoogle Scholar
  8. Lewin JR, Patterson EA (1980) CT recognition of spontaneous intraperitoneal hemorrhage complicating anticoagulant therapy. AJR Am J Roentgenol 134:1271–1272PubMedGoogle Scholar
  9. McCort J (1976) Intraperitoneal and retroperitoneal hemorrhage. Radiol Clin North Am 14:391–405PubMedGoogle Scholar
  10. New PFJ, Aronow S (1976) Attenuation measurements of whole blood fractions in computed tomography. Radiology 121:635–640PubMedGoogle Scholar
  11. Pombo F, Arrojo L, Perez Fonta J (1991) Haemoperitoneum secondary to spontaneous rupture of hepatoareolar tissue carcinoma: CT diagnosis. Clin Radiol 43:321PubMedCrossRefGoogle Scholar
  12. Radin DR (1991) Intramural and intrapenitoneal hemorrhage due to duodenal ulcer. AJR Am J Roentgeool 157:45Google Scholar
  13. Raghavendra BN, Grieco AJ, Balthazar EJ, Megibow AJ, Subramanyam BR (1982) Diagnostic utility of sonograph and computed tomography in spontaneous mesenteric hematoma. Am J Gastroenterol 77:570–573PubMedGoogle Scholar
  14. Rubin GD, Jeffrey RB Jr, Walter JF (1991) Pancreatic microcystic adenoma presenting with acute hemoperitoneum: CT diagnosis. AJR Am J Roentgenol 156:749PubMedGoogle Scholar
  15. Sivit CJ, Peclet M, Taylor GA (1989) Lifethreatening intraperitoneal bleeding: demonstration with CT. Radiology 171:430PubMedGoogle Scholar
  16. Wolverson MK, Crepps LF, Sundaram M, Heiberg E, Vas WG, Shields JB (1983) Hyperdensity of recent hemorrhage at body computed tomography: incidence and morphologic variation. Radiology 148:779–784PubMedGoogle Scholar


  1. Erb RE, Mirvis SE, Shanmuganathan (1994) Gallbladder injury secondary to blunt trauma: CT findings. J Comput Assist Tomogr 18:778–784PubMedCrossRefGoogle Scholar
  2. Sty JR. Starshack RJ, Hubbard AM (1982) Radionuclide hepatobiliary imaging in the detection of traumatic biliary tract disease in children. Pediatr Radiol 12:115–118PubMedCrossRefGoogle Scholar
  3. Vasquez JL, Thorseo MK, Dodds WJ, Quiroz FA, Martinez ML, Lawson TL, Steward ET, Foley WD (1985) Evaluation and treatment of intraabdominal bilomas. AJR Am J Roentgenol 144:933–936Google Scholar
  4. Weissmann HS, Chun KJ, Frank M, Koenigsberg M, Mlistein DM, Freeman LM (1979) Demonstration of traumatic bile leakage with cholescintigraphy and ultrasonography. AJR Am J Roentgenol 133:843–847PubMedGoogle Scholar

Urinary Collections

  1. Kane NM, Francis JR, Ellis JH (1989) The value of CT in the detection of bladder and posterior urethral injuries. AJR Am J Roentgenol 153:1243–1246PubMedGoogle Scholar
  2. Lis LE, Cohen AJ (1990) CT cystography in the evaluation of bladder trauma. J Comput Assist Tomogr 14:386–389PubMedCrossRefGoogle Scholar
  3. Lowe FC, Fishman EK, Oestenling JE, et al (1989) Computerized tomography in the diagnosis of bladder rupture. Urology 33:341–343PubMedCrossRefGoogle Scholar
  4. Mee S, McAninch J, Federle MP, et al (1987) Computerized tomography in bladder rupture: diagnostic limitations. Urol 137:207–209Google Scholar
  5. Mirvis SE (1989) Diagnostic imaging of the urinary system following blunt trauma. Clin Imaging 13:269–280PubMedCrossRefGoogle Scholar
  6. Sandler CM, Hall JT, Rodriguez MB, et al (1986) Bladder injury in blunt pelvic trauma. Radiology 158:633–638PubMedGoogle Scholar
  7. Sivit CJ, Cutting JP, Eichelberger MR (1995) CT diagnosis and localization of rupture of the bladder in children with blunt abdominal trauma: significance of contrast extravasation in pelvis. AJR Am J Roentgenol 164:1243–1246PubMedGoogle Scholar

Lymphatic Collections

  1. Dodd GD, Rutledge F, Wallace S (1970) Postoperative pelvic lymphocysts. AJR Am J Roentgenol 108:312–323Google Scholar
  2. Gillimand JD, Spies JB, Brown SB, et al (1989) Lymphoceles: percutaneous treatment with povidone-iodine sclerosis. Radiology 171:227–229Google Scholar
  3. Kim JK, Jeong TT, Kim TH, Kim TC, Kang HK, Choi HS (1999) Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage. Radiology 212:390–394PubMedGoogle Scholar
  4. Meyers AM, Levine E, Myburgh JA, et al (1977) Diagnosis and management of lymphoceles after renal transplantation. Urology 10:497–502PubMedCrossRefGoogle Scholar
  5. Petru E, Tamussino K, Lahousen M, et al (1989) Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer. Am J Obstet Gynecol 161:937–941PubMedGoogle Scholar
  6. Sweizer R, Cho S, Kountz SL, Belzer FO (1972) Lymphoceles following renal transplantation. Arch Sorg 104:42–45CrossRefGoogle Scholar
  7. Van Sonnenberg E, Mueller PR, Ferrucci JT Jr (1984) Percutaneous drainage of 250 abdominal abscesses and fluid collections: results, failures and complications. Radiology 151:337–341Google Scholar
  8. Van Sonnenberg E, Wittich GR, Casola G, et al (1986) Lymphocele: imaging characteristics and percutaneous management. Radiology 161:593–596Google Scholar
  9. White M, Mueller PR, Ferrucci JT, et al (1985) Percutaneous drainage of postoperative abdominal and pelvic lymphoceles. AJR Am J Roentgenol 145:1065–1069PubMedGoogle Scholar
  10. Zuckerman DA, Taeger TD (1997) Percutaneous ethanol sclerotherapy of postoperative lymphoceles. AJR Am J Roentgenol 169:433–437PubMedGoogle Scholar


  1. Hederstrom E, Forsberg L (1990) Entrapped ovarian cyst: an unusual case of persistent abdominal pain. Acta Radiol 31:285–286PubMedGoogle Scholar
  2. Hoffer FA, Kozakewich H, Colodny A, et al (1988) Peritoneal inclusion cyst: ovarian fluid in peritoneal adhesions. Radiology 169:189–191PubMedGoogle Scholar
  3. Kurachi H, Murakami T, Nakamura H, et al (1993) Imaging of peritoneal pseudocyst: value of MR imaging compared with sonography and CT. AJR Am J Roentgenol 160:589–591Google Scholar
  4. Mazziotti S, Blandino A, Gaeta M, Scribano E, Salamone I, Pandolfo I (2000) Pseudocisti peritoneali. Radiol Med 99:109–111PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Armando Rossi
    • 1
  • Giorgio Rossi
    • 2
  1. 1.Institute of Radiological SciencesUniversity of ParmaParmaItaly
  2. 2.Local Health Unit (ASL)Hospital of FidenzaFidenza (Pr)Italy

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