Computed tomographic features of peritoneal carcinomatosis treated by intraperitoneal chemohyperthermia.
OBJECTIVE
The purpose of this work was to describe the computed tomography (CT) features of peritoneal carcinomatosis after surgery combined with intraperitoneal chemohyperthermia (IPCH).


METHODS
Between 1999 and 2001, 51 consecutive patients (33 women and 18 men, with a mean age 45 years) were treated in our institution with IPCH for peritoneal carcinomatosis. Patients that were symptomatic (33 patients) underwent contrast enhanced helical CT of the abdomen and the pelvis during the first 15 postoperative days. The CT scans were reviewed retrospectively by two blinded observers. Computed tomography abnormalities were compared with surgical, biochemical, and clinical findings.


RESULTS
None of the CT scans were completely normal. Most postsurgical CT findings, including bowel and peritoneal thickening (14 and 13 cases, respectively), increased intraperitoneal fat density (13 cases), and compartmentalized ascites (8 cases), resulted from an inflammatory mesenteric reaction or inflammation of the small bowel or the peritoneum and did not require specific treatment. Major complications requiring appropriate treatment were intra-abdominal abscesses (5 cases), hemoperitoneum (5 cases), urinary fistula (2 cases), acute pancreatitis (1 case) and abdominal wall abscesses (2 cases).


CONCLUSIONS
Knowledge of early CT findings after therapy with surgery combined with IPCH for peritoneal carcinomatosis is useful for accurate posttreatment management of these patients.
Dromain
Clarisse
C
Department of Radiology, Institut Gustave-Roussy, Vellejuif, France. dromain@igr.fr
Bisdorff
Annouk
A
Elias
Dominique
D
Antoun
Sami
S
Boige
Valerie
V
Lasser
Philippe
P
Sigal
Robert
R
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011184:Postoperative Period; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin