Biochemistry and Molecular Biology Coming of Age

It was until recently believed, that ultrasonography is used for the examination of the solid organs only. Most of the radiologists believed that the peritoneum and its structures are to be examined by CT or MRI. This made them to a great extent unfamiliar with peritoneal Ultrasonographic anatomy as well as the pathological peritoneal conditions. Indeed, ultrasonography is the first imaging to be done in a case of ascites. With the technologic advances in ultrasound machines with the development of high resolution machines and the high-frequency transducers, examining the peritoneum with the ultrasound becomes a feasible task. This book was aimed for spreading the knowledge of ultrasound anatomy of the peritoneum and its examination technique. The reader will find this basic information in the first chapter. Next, the reader will move smoothly to be oriented with different pathological conditions of the peritoneum. The author tried simplification and clarification of Ultrasonographic diagnostic criteria in each disease entity. Differentiation between benign and malignant peritoneal diseases may also be suggested by ultrasound. Besides; the algorithm of how to diagnose a case of ascites when you first examine on ultrasonography, will be there. A second important step in the diagnosis of a case of ascites is a diagnostic aspiration of the ascitic fluid for chemical, bacteriological and cytological analysis. Aspiration can be best done under ultrasound guidance. Moreover; Ultrasound guided biopsy of extra visceral masses (lesions outside solid organs) is another advantage that ultrasound can offer in the diagnosis of difficult group of patients with ascites due to peritoneal diseases. Peritoneal biopsy was once believed to be performed by laparscopy or laparotomy. Ultrasound guided peritoneal biopsy is now replacing the laparoscopic biopsy of peritoneal lesions in a safe, effective and a minimally invasive manner. The technique of ultrasound guided peritoneal biopsy and the author's experience in this regards will be written in details. I hope for the reader to find the information in this book easy and palatable. I hope that every sonographer who has finished reading this book will train him or herself on examining the peritoneum, picking up the diseases. I hope one day that the ultrasound capabilities of diagnosis as well as the interventional procedures is no more underestimated by the sonographers, the gastroenterologists, the surgeons or the oncologists. Many countries in the world have no much sophisticated imaging facilities; Ultrasound is the first imaging investigation to be done in a patient with an abdominal complaint. Thanks to ultrasound; being the only real-time imaging, the safest with no exposure to ionizing radiation, the most readily available and easily repeatable of all the imaging procedures. Thanks for its high sensitivity and its Doppler capabilities that made ultrasound guided biopsy a safer procedure. I hope by the end of this book that the medical practice in a case of ascites is going to be changed by a group of open-minded trained motivated sonographers and clinicians in each country.