Peritoneum: Location, Nerve Supply, Diseases, Symptoms, Diagnosis and Treatment

Peritoneum is a membrane, a sheet of smooth tissue that lines your abdominal and pelvic cavity and protects your internal organs. It keeps your organs in position, cushions and insulates them, and secretes a lubricant to minimize friction when they rub against one another. 

Your organs are surrounded by the visceral peritoneum, whereas the parietal peritoneum lines the walls of your pelvis and abdomen. Your peritoneal cavity is the term for the space between.

Structure Of Peritoneum

A serous membrane, or one that secretes serum, is your peritoneum. This type of tissue, known as mesothelium, lines several of your body cavities. Epithelial cells make up the top layer and connective tissue makes up the bottom layer.

The epithelial cells transport blood, lymph, and nerve supplies while secreting and absorbing fluid, filtering out foreign objects. Connective tissue holds everything together. Some of your organs are suspended inside the cavity while others are attached to your abdominal wall.

Location Of Peritoneum

The peritoneum's location is unknown. Your abdominopelvic cavity lies between your diaphragm and pelvic floor. It includes your abdominal cavity and pelvic cavity. Your parietal peritoneum lines the walls of this space. 

Your stomach, liver, spleen, and a portion of your small and large intestines are just a few of the abdominal organs that are surrounded by your visceral peritoneum. The term "intraperitoneal" refers to internal organs in the visceral peritoneum. All of the rest are "retroperitoneal."

Formations Of Peritoneum

When your visceral peritoneum wraps around your organs, it folds back on itself, forming pouches and multiple layers here and there. The front of your abdomen is covered like an apron by a huge double layer known as the omentum. 

Your intestines are connected to your back abdominal wall by a double layer known as the mesentery. Adipose tissue, the fat in between the layers, carries neurovascular supply to your organs and offers additional insulation and protection.

Nerve supply Of Peritoneum

The visceral peritoneum that surrounds your abdominal organs receives its supply of autonomic nerves from the same location. It experiences diffuse, challenging-to-localize gut agony. Your digestive system stretches when it is filled with food or gas. 

Additionally, it detects irritants that are chemical, such as blood or bile leaks. The somatic nerve supply to your abdominal wall, which it covers, is shared by your parietal peritoneum. It is capable of sensing temperature, discomfort, and localized Pressure.

Function Of Peritoneum

Scientists are still learning about some of the functions that your peritoneum performs. It gives:

• Insulation. The peritoneum's layers of fat keep your organs warm and secure.
• Lubrication. The organs that move inside your peritoneal cavity are lubricated by peritoneal fluid.
• Structure. The peritoneum contains ligaments that bind your intestines to your back abdominal wall and connect your organs to one another.
• Supplies of lymph, blood, and nerves. Your peritoneum is made up of layers that are interconnected by nerves and blood arteries.
• Immunity. In your abdominal cavity, your peritoneum acts as a protective barrier against harm and germs. It deploys white blood cells to attack invading particles once it detects them. It removes waste materials and filters fluids in your peritoneal cavity. Additionally, the tissue has the ability to heal itself quickly.

The peritoneum is affected by what diseases or conditions?

• Peritonitis. The term "peritonitis" refers to peritoneal inflammation. Peritonitis, which is frequently brought on by an infection in the peritoneal cavity, can also be an early sign of a wide range of gastrointestinal conditions. Because of the peritoneum's capacity for absorption, peritonitis is handled as an emergency. Septicemia is a condition when an infection that starts in the peritoneal cavity spreads throughout the body after entering the general bloodstream.
• Ascites. Your peritoneal cavity might become overfilled with fluid, which is known as ascites. Your abdomen swells mysteriously as a result. It is typically a sign of cirrhosis, a form of advanced liver disease that causes hypertension in the portal vein in your belly and leaky veins. Congestive heart failure or cancer can occasionally cause it.
• Hernia. A hernia develops when tissue from one cavity of your body pushes through the muscular wall into another. The peritoneum is the most often affected tissue and most hernias happen through one of your abdominal walls. Even when an organ from your viscera pulls through, the peritoneum is most likely still covering it. Unless they lose their blood supply, hernias often do not cause injury to the peritoneum. Surgery, however, might be necessary to fix them.
• Abdominal adhesions. The peritoneum can develop rings of tenacious scar tissue following abdominal surgery that cuts through it. While abdominal adhesions don't necessarily result in difficulties, if they grow in the spaces where your organs normally move around one another, they may prevent movement.
• A bowel obstruction is the most harmful risk they can bring about. Food cannot pass through or exit your intestines if they are clogged.
• Sclerosing panniculitis (mesenteric panniculitis). The fatty tissue in your mesentery, the fold of your peritoneum that connects your small intestine to the rear wall of your abdomen, is affected by this uncommon illness. It resembles a severe case of abdominal adhesions in your mesentery. Chronic tissue inflammation causes widespread scarring (fibrosis) for unknown reasons. Necrosis, which occurs when blood flow to a tissue is stopped, can be brought on by fibrosis, and it can also occasionally result in intestinal blockage.
• Lymphadenitis of the mesentery. Your lymph nodes become swollen and inflamed when you have lymphadenitis. When it affects your mesentery, it is known as mesenteric lymphadenitis. It typically indicates an infection.
• When your immune system is active, lymph nodes help filter out infections and bacteria. Fever and soreness are potential side effects, but they're typically transient.
• Cancer. Your peritoneum can readily become infected with cancer from your abdominal and pelvic organs. Peritoneal carcinomatosis is what this is known as. There are also sporadic cases where cancer can start. Peritoneal mesothelioma (cancer of the mesothelium) and primary peritoneal carcinoma are two instances. Pseudomyxoma peritonei is an uncommon kind of cancer that causes the peritoneal cavity to fill with a mucus-like substance. Your peritoneum can develop cancer, and it has the potential to spread to other organs.

What symptoms would indicate peritoneal problems?

Any disorder that affects your peritoneum will most likely cause abdominal pain and swelling.

Your visceral peritoneum, the internal layer of your tummy, maybe the source of any vague or diffuse abdominal pain. An inflamed outer parietal layer may be the cause of more severe pain. There are numerous reasons why you could experience abdominal pain, but your peritoneum is involved in many of them.

Diagnosis Of The Diseases Associated With The Peritoneum

• Analyses of peritoneal fluid. To determine if you have peritonitis or ascites, medical professionals examine a sample of your peritoneal fluid. By putting a hollow needle into your peritoneal cavity and drawing out a small amount, they take a sample. Then they ship it to the lab. They can determine whether the fluid is due to inflammation or to blood vessels that are leaking by examining the contents. Additionally, they may discover indications of an infection, malignancy, or chemical leaks.
• Biopsy of the peritoneum. Your healthcare professional may occasionally need to examine a sample of your peritoneal tissue. A specific needle that is placed into your belly might be used to collect the sample (needle biopsy). They can also collect a sample during a laparoscopy, which is a minimally invasive examination of your abdominal cavity with a tiny camera. If they need to see inside your abdomen to determine what's going on, they might recommend a laparoscopy and biopsy.

Treatment Options For The Peritoneum

• Dialysis of the peritoneum. Because the peritoneum is so good at removing waste, medical professionals may employ it in place of dialysis to treat patients with kidney failure.
• By eliminating waste materials and extra fluid from your blood, dialysis performs the function of your kidneys. You or your doctor will inject a fluid solution into your peritoneal cavity during the procedure. The fluid is filtered by your peritoneum before being removed by you or a medical professional.
• Intraperitoneal hyperthermic chemotherapy (HIPEC). Utilizing the absorbent qualities of your peritoneum, HIPEC is a novel, targeted method of chemotherapy. You receive a concentrated, heated chemotherapeutic solution right into your peritoneal cavity. HIPEC can treat any localized cancer that has spread to your peritoneal cavity. This is a distinctive substitute for conventional chemotherapy, which is systematically injected into the bloodstream and is linked to a variety of negative side effects. It could also be more efficient.
• Debulking and cytoreductive surgery. Surgery and chemotherapy are frequently used to treat cancer of the abdominopelvic cavity. Any cancer cells that are present are removed using cytoreductive or debulking surgery. Sometimes, that entails having your peritoneum partially or completely removed (peritonectomy). Your omentum is the most frequently impacted area. Some cancers have a tendency to spread there first, and occasionally, an omentectomy can eliminate it.

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