Secondary peritonitis echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]

Overview

Ultrasound may be positive in unto 72%. US is recommended as a screening test for acute abdomen and strongly recommended particularly when AAA rupture or acute cholecystitis is suspected. US is recommended in pregnant women, young women, or children in whom radioactive exposure is not desirable.

Key Ultrasound Findings in Secondary peritonitis

• Abdominal ultrasonography may be helpful in the evaluation of pathology in the right upper quadrant (eg, perihepatic abscess, cholecystitis, pancreatitis, pancreatic pseudocyst), right lower quadrant, and pelvis (eg, appendicitis, tubo-ovarian abscess, Douglas pouch abscess).
• However, the examination is sometimes limited because of patient discomfort, abdominal distention, and bowel gas interference.
• Ultrasonography may detect increased amounts of peritoneal fluid (ascites), but its ability to detect quantities of less than 100 mL is limited.
• A diagnostic accuracy of greater than 85% has been reported in several series.
• Ultrasonographically guided aspiration and placement of drains has evolved into a valuable tool in the diagnosis and treatment of abdominal fluid collections.
• Advantages of ultrasound include low cost, portability, and availability.
• Disadvantages are that the test is operator dependent, and there is reduced visualization in the presence of overlying bowel gas and abdominal dressings.