Mesenteric, omental, and retroperitoneal edema in cirrhosis: Frequency andspectrum of CT findings

PURPOSE: To determine the frequency and CT imaging spectrum of mesenteric, omental, and retroperitoneal edema in patients with:cirrhosis. MATERIALS AND METHODS: Eighty patients-were identified with liver cirrhosis and no other cause of edema. Five radiologists jointly reviewed the abdomi nal CT scans Of these patients to assess, by majority decision, the presenc e, severity, distribution,and configuration of mesenteric edema, and the pr esence of omental and retroperitoneal ebema; Subcutaneous edema, ascites, p leural effusion, splenomegaly, varices, portal venous-thrombosis, and-serum albumin levels were also documented. RESULTS: Mesenteric edema was present in 69 (86%) patients.: Mesenteric ede ma occurred alone in 26 (38%) and with omental or retroperitoneal edema in 40 (58%) of the 69 patients with edema. No patient had mental or retroperit oneal edema alone. Mesenteric edema was mild in 51 (74%) and moderate to se vere in 18 (26%); patchy in 47 (68%) and diffuse in 22 (32%), purely infilt rative in 60 (87%) and infiltrative with superimposed masslike nodules in n ine (13%) patients. These parameters had significant associations among the mselves: and with ascites, pleural effusions, subcutaneous edema, and low-m ean serum albumin levels but not with splenomegaly or varices. CONCLUSION: Mesenteric, omental, and retroperitoneal edema;occur commonly i n patients with cirrhosis. The appearance of mesenteric edema varies from a :mild infiltrative haze to a severe masslike sheath that engulfs the mesent eric vessels.