peritonitis and end ileostomy by borko kereshi, msiii
TRANSCRIPT
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Peritonitis and End Ileostomy
By Borko Kereshi, MSIII
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The case
• 48 year old female with end-stage renal disease and history of pancreatitis.
• Status post colectomy for ischemic colitis.
• End Ileostomy placed
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What do you see?
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FindingsEnd ileostomy
Parastomial hernia with free fluid around ileostomy
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Parastomial hernia with free fluid around ileostomy
![Page 6: Peritonitis and End Ileostomy By Borko Kereshi, MSIII](https://reader030.vdocument.in/reader030/viewer/2022032709/56649eb15503460f94bb7253/html5/thumbnails/6.jpg)
What do you see?
![Page 7: Peritonitis and End Ileostomy By Borko Kereshi, MSIII](https://reader030.vdocument.in/reader030/viewer/2022032709/56649eb15503460f94bb7253/html5/thumbnails/7.jpg)
Findings
Thickened and enhancing peritoneum, consistent with peritonitis.
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Peritonitis, cause and result
• Diffuse peritonitis occurs when the cause of the peritoneal inflammation is not contained or there is overwhelming infection. Generalized peritonitis can result from infective or chemically irritative causes.
• On CT, there is smooth peritoneal contrast enhancement
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Fat stranding around the pancreatic tail. This could be part of peritonitis. Alternatively this may be secondary to focal pancreatic tail inflammation
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Abnormal fluid collection anterior to liver
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Coronal View
Fluid!
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More fluid!
![Page 13: Peritonitis and End Ileostomy By Borko Kereshi, MSIII](https://reader030.vdocument.in/reader030/viewer/2022032709/56649eb15503460f94bb7253/html5/thumbnails/13.jpg)
References
• K Gordon, WK Lee, O Hennessy. Computed tomography manifestations of peritoneal diseases. Australasian Radiology. VL: 49. NO: 4. 2005. Department of Medical Imaging, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia.