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American Journal of Obstetrics and... Aug 2003In our specialty, the practice of closing or not closing the peritoneum is still being debated. Our purpose was to review the literature on the subject, to evaluate the... (Review)
Review
In our specialty, the practice of closing or not closing the peritoneum is still being debated. Our purpose was to review the literature on the subject, to evaluate the advantages and disadvantages of the procedure, and to provide clinical opinions. Closure of the peritoneum either parietal or visceral peritoneum is unnecessary, it is associated with a slightly longer operating time and more postoperative pain, and there are some suggestions that it might cause more adhesion formation. There are more advantages than disadvantages to not closing the peritoneum. We encourage clinicians not to close both parietal and visceral peritoneum.
Topics: Animals; Cesarean Section; Gynecologic Surgical Procedures; Humans; Peritoneum; Randomized Controlled Trials as Topic; Regeneration; Surgical Procedures, Operative; Sutures; Wound Healing
PubMed: 14520243
DOI: 10.1067/s0002-9378(03)00299-0 -
Cancer Treatment and Research 2007
Review
Topics: Ascites; Capillaries; Carcinoma; Humans; Peritoneal Neoplasms; Peritoneum; Regional Blood Flow
PubMed: 17633049
DOI: 10.1007/978-0-387-48993-3_6 -
Current Opinion in Nephrology and... Nov 2006The peritoneal membrane provides the interface between dialysate fluid and blood for peritoneal dialysis patients. Functional properties of the peritoneal membrane have... (Review)
Review
PURPOSE OF REVIEW
The peritoneal membrane provides the interface between dialysate fluid and blood for peritoneal dialysis patients. Functional properties of the peritoneal membrane have important clinical implications. This review will outline recent observations concerning structural changes in the peritoneal membrane and the impact on function and clinical outcomes.
RECENT FINDINGS
Peritoneal membrane function - solute transport and ultrafiltration - is a complex process involving new blood vessel growth along with changes in the nature of blood vessels and the interstitial environment of these vessels. Advanced glycation end-products produced by reactive oxygen species in the dialysis fluid have been identified as an agent of tissue fibrosis. Nitric oxide and IL-6 also have important roles in peritoneal membrane injury. Gene polymorphisms associated with peritoneal membrane function have been identified. As the mechanisms of peritoneal membrane injury become better elucidated, targeted therapies are being developed. The role of biocompatible and nonglucose dialysis fluids needs to be further defined.
SUMMARY
The peritoneal membrane is the lifeline for peritoneal dialysis patients. Our understanding of mechanisms of injury and functional responses continues to expand and will hopefully lead to therapies to improve the clinical outcomes for peritoneal dialysis patients.
Topics: Animals; Biological Transport; Humans; Membranes; Peritoneal Dialysis; Peritoneum
PubMed: 17053469
DOI: 10.1097/01.mnh.0000247500.41420.94 -
Communications Biology Aug 2021The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of...
The position of abdominal organs, and mechanisms by which these are centrally connected, are currently described in peritoneal terms. As part of the peritoneal model of abdominal anatomy, there are multiple mesenteries. Recent findings point to an alternative model in which digestive organs are connected to a single mesentery. Given that direct evidence of this is currently lacking, we investigated the development and shape of the entire mesentery. Here we confirm that, within the abdomen, there is one mesentery in which all abdominal digestive organs develop and remain connected to. We show that all abdominopelvic organs are organised into two, discrete anatomical domains, the mesenteric and non-mesenteric domain. A similar organisation occurs across a range of animal species. The findings clarify the anatomical foundation of the abdomen; at the foundation level, the abdomen comprises a visceral (i.e. mesenteric) and somatic (i.e. musculoskeletal) frame. The organisation at that level is a fundamental order that explains the positional anatomy of all abdominopelvic organs, vasculature and peritoneum. Collectively, the findings provide a novel start point from which to systemically characterise the abdomen and its contents.
Topics: Humans; Mesentery; Peritoneum
PubMed: 34408242
DOI: 10.1038/s42003-021-02496-1 -
Contributions To Nephrology 2006The peritoneal membrane has the surface area similar to the body surface area. It consists of mesothelial cells, interstitium, connective tissue fibers, blood vessels,... (Review)
Review
The peritoneal membrane has the surface area similar to the body surface area. It consists of mesothelial cells, interstitium, connective tissue fibers, blood vessels, and lymphatics. Solutes of various sizes traverse the peritoneal membrane through at least three various pores: 'large' pores located in the venular interendothelial gaps, small 'paracellular' pores, and ultrasmall, 'transcellular' pores or aquaporins localized in peritoneal capillaries and mesothelial cells. High molecular weight solutes are mass-transfer limited; thus, their clearances do not increase significantly with high dialysate flow. Clearances of small molecular weight solutes are dialysate flow limited. Ultrafiltration is proportional to the hydrostatic and osmotic transmembrane pressures. The peritoneum offers greater resistance to accompanying solutes than to water (solute sieving), so that the concentration of solutes in the ultrafiltrate is less than in plasma water. Sodium sieving leads to hypertension, which is frequently observed in patients treated with short-dwell or continuous flow peritoneal dialysis. Peritoneal equilibration test is the most commonly used test to characterize peritoneal function and select the most suitable dialysis technique for a patient. Long-term peritoneal dialysis is associated with progressive loss of ultrafiltration capability due to structural and functional alterations in the membrane mostly as the consequence of exposure to glucose degradation products or advanced glycation end products generated during the sterilization process.
Topics: Biological Transport; Body Water; Dialysis Solutions; Diffusion; Humans; Peritoneal Dialysis; Peritoneum
PubMed: 16720986
DOI: 10.1159/000093443 -
Internal Medicine (Tokyo, Japan) 2008
Topics: Adult; Female; Humans; Peritoneum; Peritonitis; Sclerosis; Tomography, X-Ray Computed
PubMed: 18670153
DOI: 10.2169/internalmedicine.47.1252 -
Seminars in Nuclear Medicine Sep 2020The peritoneum is the largest and most complex serous membrane in the human body. The peritoneal membrane is composed of a layer of mesothelium supported by a thin layer... (Review)
Review
The peritoneum is the largest and most complex serous membrane in the human body. The peritoneal membrane is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum is one continuous sheet, forming two layers and a potential space between them - the peritoneal cavity- which is subdivided into multiple communicating spaces containing small amount of serous fluid that facilitates frictionless movement of mobile intraabdominal viscera. Peritoneum also contributes to fluid exchange mechanism and plays a role in immune response. The peritoneum is subject to many neoplastic and non-neoplastic processes including infections, trauma, developmental and inflammatory processes. Different Nuclear Medicine imaging techniques can be used to diagnose peritoneal diseases, most of these techniques can be customized depending on the clinical scenario and expected findings. Peritoneal scintigraphy can detect abnormal peritoneal communication or compartmentalization. Several nuclear medicine techniques can help characterize intraperitoneal fluid collections and differentiate sterile from infected fluid. PET imaging plays an important role in imaging of different neoplastic and non-neoplastic peritoneal pathologies. Nuclear radiologists need to be familiar with peritoneal anatomy and pathology to interpret peritoneal findings in dedicated peritoneal nuclear medicine imaging studies, as part of more general nuclear medicine scans, or on CT or MRI component of hybrid imaging studies. The purpose of this article is to review the normal peritoneal anatomy, various pathologic processes involving the peritoneum, and different nuclear medicine and hybrid imaging techniques that can help detect, characterize, and follow up peritoneal pathology.
Topics: Humans; Nuclear Medicine; Peritoneum
PubMed: 32768005
DOI: 10.1053/j.semnuclmed.2020.04.005 -
International Journal of Biological... 2021Postoperative adhesions (PA) are fibrotic tissues that are the most common driver of long-term morbidity after abdominal and pelvic surgery. The optimal drug or material... (Review)
Review
Postoperative adhesions (PA) are fibrotic tissues that are the most common driver of long-term morbidity after abdominal and pelvic surgery. The optimal drug or material to prevent adhesion formation has not yet been discovered. Comprehensive understanding of cellular and molecular mechanisms of adhesion process stimulates the design of future anti-adhesive strategies. Recently, disruption of peritoneal mesothelial cells were suggested as the 'motor' of PA formation, followed by a cascade of events (coagulation, inflammation, fibrinolysis) and influx of various immune cells, ultimately leading to a fibrous exudate. We showed that a variety of immune cells were recruited into adhesive peritoneal tissues in patients with small bowel obstruction caused by PA. The interactions among various types of immune cells contribute to PA development following peritoneal trauma. Our review focuses on the specific role of different immune cells in cellular and humoral mechanisms underpinning adhesion development.
Topics: Animals; Fibrosis; Humans; Peritoneum; Tissue Adhesions
PubMed: 33390851
DOI: 10.7150/ijbs.54403 -
Seminars in Cell & Developmental Biology Aug 2019The peritoneum is a large serous membrane with both epithelial and mesenchymal features, and is essential for maintaining an intra-abdominal homeostatic equilibrium. The... (Review)
Review
The peritoneum is a large serous membrane with both epithelial and mesenchymal features, and is essential for maintaining an intra-abdominal homeostatic equilibrium. The peritoneum plays a central role in the pathogenesis of a number of disorders. Pathological processes affecting the peritoneum such as inflammation and carcinomatosis can have serious clinical consequences, but the pathophysiology of these conditions is poorly understood. Understanding peritoneal embryology, anatomy and physiology is crucial to comprehend pathophysiological mechanisms and to devise a new focus for research. The vascular response to pathological processes appears to be of considerable importance, since the peritoneal vasculature plays a pivotal role in most associated diseases. Therefore, this review summarizes currently available literature with special emphasis on the development, anatomy and function of the peritoneal vasculature. Pathological processes are described to illustrate physiological and pathophysiological characteristics of the peritoneum.
Topics: Humans; Peritoneum
PubMed: 30253239
DOI: 10.1016/j.semcdb.2018.09.007 -
Radiographics : a Review Publication of... 2012It is difficult to identify normal peritoneal folds and ligaments at imaging. However, infectious, inflammatory, neoplastic, and traumatic processes frequently involve... (Review)
Review
It is difficult to identify normal peritoneal folds and ligaments at imaging. However, infectious, inflammatory, neoplastic, and traumatic processes frequently involve the peritoneal cavity and its reflections; thus, it is important to identify the affected peritoneal ligaments and spaces. Knowledge of these structures is important for accurate reporting and helps elucidate the sites of involvement to the surgeon. The potential peritoneal spaces; the peritoneal reflections that form the peritoneal ligaments, mesenteries, and omenta; and the natural flow of peritoneal fluid determine the route of spread of intraperitoneal fluid and disease processes within the abdominal cavity. The peritoneal ligaments, mesenteries, and omenta also serve as boundaries for disease processes and as conduits for the spread of disease.
Topics: Abdominal Cavity; Adult; Aged; Ascites; Diagnostic Imaging; Female; Humans; Ligaments; Magnetic Resonance Imaging; Male; Mesentery; Middle Aged; Multidetector Computed Tomography; Peritoneal Cavity; Peritoneum; Peritonitis; Retroperitoneal Space; Tomography, X-Ray Computed; Ultrasonography; Viscera
PubMed: 22411941
DOI: 10.1148/rg.322115032