Axis Longitudinal

Axis Transversal

KETERANGAN
1: Aorta
5: A. Lienalis
7: A. Mesenterika
superior
20: Lobus dextra hepar
40: Pankreas
73: Antrum Gaster

KETERANGAN
1: Aorta
7: A. Mesenterika
superior
10: Vena Cava Inferior
20: Lobus dextra hepar
40: Pankreas
50: Lien
60: Ren dextra
61: Ren sinistra
70: Gaster
90: Corpus Vertebra

KETERANGAN
20: Lobus dextra hepar
30: Vesica fellea
60: Ren dextra
76: Duodenum

KETERANGAN
20: Lobus dextra hepar
21: Lobus sinistra hepar
50: Lien
60: Ren dextra
61: Ren sinistra
70: Gaster

KETERANGAN
1: Aorta
7: A. Mesenterika
superior
10: Vena cava inferior
19: V. Mesenterika
superior
20: Lobus dextra hepar
21: Lobus sinistra hepar
40: Pankreas
50: Lien
60: Ren dextra
61: Ren sinistra
70: Gaster
90: Corpus vertebra

Normal
Peritoneal
stripe line

Normal
intraluminal
bowel gas

Sonogram shows intraluminal bowel gas (curvedarrows) always

associated with normal and more superficial peritoneal stripe (straight
arrows).

Tanda Pneumoperitoneum
pada USG

Direct Signs

Indirect Signs

Increased
echogenity
of Intraperitoneal free fluid
Air bubbles in ascitic fluid
peritoneal stripe
Air in around duodenum or Thickened
bowel
perforated bowel
loop/gallbladder wall
Air above the liver, does not
move
with
respiration,
moveable
with
patient
repositioning

Peritoneal stripe
line
Angiocathe
ter

Intraperitoneal
Fluid

A, Baseline sonogram of pig abdomen shows

normal thin peritoneal stripe (arrows).
Intraperitoneal fluid (P) was infused, and
angiocatheter (arrowheads) was inserted
for subsequent injection of intraperitoneal air.

Normal peritoneal
stripe line

Air bubble in
overlapping
with
peritoneal
stripe line

Sonogram obtained after injection of tiny air bubble shows focal

enhancement of peritoneal stripe (large arrow) without associated
posterior artifact Note adjacent normal peritoneal stripe (small arrows).

Normal peritoneal
stripe line as double
line

Rectus
muscle

Normal bowel
gas

Fig. 2-42-year-old healthy female volunteer.

A, Magnified sonogram shows normal peritoneal stripe (arrows) appearing as double
line deep in relation to rectus muscle (R).
B, Magnified sonogram shows intraluminal bowel gas (curvedarrows) always
associated with normal and more
superficial peritoneal stripe (straight arrows)

Normal
Peritoneal
stripe

Focal
enchancement
of peritoneal
stripe
Dirty
Shadowing

A, Curved array transverse sonogram of right upper quadrant

shows focal enhancement of peritoneal stripe (large arrow)
with associated dirty shadowing (open arrows)
associated with pockets of free air around liver. Note normal
adjacent peritoneal stripe (small solid arrows)

Gas within
lungs
Free air in
anterior of
liver
Obscuring
parenchym

Small free
gas outside
gallbladder

Tanda Peritonitis pada USG

Peritonitis is defined as diffuse inflammation of the
parietal and visceral peritoneum. It may occur as a
result of infectious or noninfectious causes.
1. Infectious bacterial (including tuberculosis),
viral, fungal, and parasitic infections.
2. Non-infectious

chemical
peritonitis
(secondary to gastric or pancreatic juice or bile),
granulomatous peritonitis (secondary to
3. foreign bodies such as talc), and sclerosing
peritonitis )

The US appearances of infective

peritonitis include loculated ascites or
asciticfluid that contains debris, gas, or
septa (10,14). Diffuse thickening of the
peritoneum, omentum, and mesentery
may also be observed (Fig 22). US is
superior to CT in demonstrating the
complexity of the fluid in these cases.

PERITONITI
S
INFEKSIUS
NON-TB

Peritonitis TB
Three types of tuberculous peritonitis
have been described:
(a)awet type with free or loculated fluid;
(b)adrytype with caseous nodules and
adhesions; and
(c)A fibrotic-fixed type with mass
formation consisting of omentum and
loops
of
intestine
or
mesentery,
sometimes with ascites (41).

WET TYPE

WET TYPE

WET TYPE

WET TYPE

WET TYPE

DRY TYPE

A, BUltrasonography shows multile

enlarged tuberculous lymph nodes

FIBROTIC TYPE

SCLEROSIS
PERITONITIS