小网膜囊

MATERIALS AND METHODS
intavenous contrast media were administered in each case. Scans were performed at 1-cm intervals through the upper abdomen. Coronal and sagittal reformatting were performed in selected cases to define better the anatomic relationships of the lessen sac.
pararenal space. Four other patients had small bowel loops
1
From the University
of California
at San Francisco,
San Francisco
General
Hospital,
San Francisco,
BODY
COMPUTED
TOMOGRAPHY
Computed Tomography of the Lesser Peritoneal Sac1
R. Brooke Jeffrey, M.D., Michael P. Federie, M.D., and Philip C. Goodman, M.D.
Computed tomography (CT) was the primary diagnostic modality used in the evaluation of 14 patients with 15 surgically proved lesions of the lesser peritoneal sac. CT accurately 10calized 14 of the 15 abnormalities to the lesser sac. When combined with clinical information, CT correctly suggested the preoperative diagnosis in 13 of 15 lesions. The lesser sac abnormalities included a variety of pathologic entities: pseudocysts, abscesses, hematomas, a perforated gastric ulcer, a biloma, and a malignant neopiasm. The CT anatomy of the normal and abnormal lesser sac is discussed, with emphasis on its various compartments and recesses.
it did not extend between the stomach and pancreas.
Pancreatic abscess: In three of four patients with pancreatic abscesses CT demonstrated multiple gas bubbles within a lesser sac fluid collection (Fig. 3). The CT numbers of these fluid collections ranged from 8 to 18 Hounsfield units (HU). All four patients demonstrated other
were not visualized
The region of the lesser sac was reviewed in 50 patients with normal CT scans of the upper abdomen. The configunation of the interface between the stomach and pancreas was noted, as well as all visualized penitoneal reflections of the lessen sac. The CT scans and medical records of 14 patients with 15 surgically proved lesions of the lesser sac were neviewed. The abnormalities included six lessen sac pseudocysts, four abscesses, two hematomas, and one case each of a perforated gastric ulcer, a post-traumatic biloma, and a liposarcoma secondarily invading the lesser sac. All scans were performed on either a G. E. CT/T 7800 on 8800
fat within the anterior pararenal space. reflections of the lessen sac, such
ligament or the gastnophnenic ligament,
The other penitoneal as the splenonenal
scan
time.
Both
oral
and
toneal sac have long been of interest to radiologists. Prior to computed tomography (CT), the diagnosis of suspected lesser sac abnormalities was based on indirect evidence from abdominal plain radiographs and contrast studies of the upper gastrointestinal tract (1-8). However, both the nature and extent of lesser sac abnormalities are often difficult to determine by conventional techniques alone. Although the presence of retrogastric air fluid levels or gas bubbles strongly suggests a lesser sac abscess (2), a soft-tissue mass anteriorly displacing the stomach is nonspecific and may be secondary to a lessen sac on pancreatic pseudocyst, neoplasm, hemorrhage, or phlegmon (1). CT can distinguish intra- from extnapancreatic lesions and can directly image the region of the lesser sac. The purpose of this paper is to review the normal anatomy of the lessen sac in axial projection and to demonstrate the usefulness of CT in directly imaging a variety of lesser sac lesions.
INDEX TERMS:
graphy
#{149} Peritoneal
Abdomen, anatomy #{149} Abdomen, computed sac #{149} (Lesser peritoneal sac, computed
October 1981
tomography, tomography,
in this series of normal patients. The CT appearance of the interface between the stomach and pancreas was quite variable and related to a number of factors. These included the configuration of the stomach, degree of gastric distention, the amount of fat in the anterior pananenal space, and the degree of pancreatic atrophy. In 42 of 50 patients (84 %) the Gastrografin (meglumine diatrizoate) filled stomach was within 2 cm of the body of the pancreas. Greaten distances were observed in four patients with extensive fat in the anterior
7(0).121 1 #{149} Peritoneum, 7[935].121 1)
computed
:117-122,
T
HE COMPLEX
anatomic
relationships
of the lesser
pen-
unit
using
a 4.8 on 5.7-second