John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Non-tumoral peritoneal diseases Volume 21, issue 8, Octobre 2014


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1 Hôpital Beaujon,
pôle des maladies de l’appareil digestif,
service de gastroentérologie,
MICI, assistance nutritive,
100 Boulevard du Général Leclerc,
92110 Clichy, France
2 Hôpital Beaujon,
service de radiologie,
100 Boulevard du Général Leclerc,
92110 Clichy, France
* Tirés à part

The peritoneum is a fatty, support tissue. It has close ties with abdominal organs for which it provides vascularization and motility. Also, the peritoneum has hormonal and immunologic functions. Diseases of the peritoneum are not well known and revealing clinical presentation lacks specificity. Spontaneous bacterial peritonitis in the setting of cirrhosis and neoplastic pathologies asides, diseases of the peritoneum are rare. Spontaneous peritonitis of infectious origin, whose diagnosis is largely guided by the clinical context, and non-infectious peritonitis, which may reveal a systemic disease, can be distinguished. Familial Mediterranean fever is a hereditary, non-infectious, peritonitis suspected in the setting of stereotyped recurrent acute abdominal pain crisis, associated with fever. Diagnosis is usually confirmed by analysis of the MEFV gene.

Performances of abdominal imaging have led to commonly identify regional increase in mesenteric fat density called “misty mesentery”. Its clinical significance remains to be defined and understood. When combined with lymph nodes >10 mm, this aspect may reveal underlining abdominal tuberculosis, a lymphoma or an abdominal liposarcoma. In other cases, and in the absence of a known systemic or local inflammatory cause, this aspect is consistent with a benign and rarely symptomatic disease called mesenteric panniculitis.