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Axis Longitudinal

1Axis Transversal

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KETERANGAN1: Aorta5: A. Lienalis7: A. Mesenterika superior20: Lobus dextra hepar40: Pankreas73: Antrum Gaster3

KETERANGAN1: Aorta7: A. Mesenterika superior10: Vena Cava Inferior20: Lobus dextra hepar40: Pankreas50: Lien60: Ren dextra61: Ren sinistra70: Gaster90: Corpus Vertebra4

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KETERANGAN20: Lobus dextra hepar30: Vesica fellea60: Ren dextra76: Duodenum7

KETERANGAN20: Lobus dextra hepar21: Lobus sinistra hepar50: Lien60: Ren dextra61: Ren sinistra70: Gaster8

KETERANGAN1: Aorta7: A. Mesenterika superior10: Vena cava inferior19: V. Mesenterika superior20: Lobus dextra hepar21: Lobus sinistra hepar40: Pankreas50: Lien60: Ren dextra61: Ren sinistra70: Gaster90: Corpus vertebra9

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13Sonogram shows intraluminal bowel gas (curvedarrows) always associated with normal and more superficial peritoneal stripe (straight arrows).

Normal Peritoneal stripe lineNormal intraluminal bowel gas14Tanda Pneumoperitoneum pada USGDirect SignsIndirect SignsIncreased echogenity of peritoneal stripeAir in around duodenum or perforated bowelAir above the liver, does not move with respiration, moveable with patient repositioningIntraperitoneal free fluidAir bubbles in ascitic fluidThickened bowel loop/gallbladder wall15

Peritoneal stripe lineIntraperitoneal FluidAngiocatheterA, Baseline sonogram of pig abdomen shows normal thin peritoneal stripe (arrows). Intraperitoneal fluid (P) was infused, and angiocatheter (arrowheads) was insertedfor subsequent injection of intraperitoneal air.16Sonogram 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).

Air bubble in overlapping with peritoneal stripe lineNormal peritoneal stripe line17

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19Fig. 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 moresuperficial peritoneal stripe (straight arrows)

Normal peritoneal stripe line as double lineRectus muscleNormal bowel gas20A, 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)

Dirty ShadowingFocal enchancement of peritoneal stripeNormalPeritoneal stripe21

Gas within lungsFree air in anterior of liverObscuring parenchymSmall free gas outside gallbladder22Tanda Peritonitis pada USGPeritonitis is defined as diffuse inflammation of the parietal and visceral peritoneum. It may occur as a result of infectious or noninfectious causes.

Infectious bacterial (including tuberculosis), viral, fungal, and parasitic infections.Non-infectious chemical peritonitis (secondary to gastric or pancreatic juice or bile), granulomatous peritonitis (secondary toforeign bodies such as talc), and sclerosing peritonitis )23The 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.24PERITONITIS INFEKSIUS NON-TB

25Peritonitis TBThree 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).26WET TYPE

27WET TYPE

28WET TYPE

29WET TYPE

30WET TYPE

31DRY TYPEA, BUltrasonography shows multile enlarged tuberculous lymph nodes (LN/N) and ascites.

32FIBROTIC TYPE

33SCLEROSIS PERITONITIS

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