The peritoneum is a thin membrane that lines the abdomen and pelvis, producing a lubricating fluid and keeping organs in place. It is sensitive to pain and diseases within it can spread widely, including rare cancers like malignant peritoneal mesothelioma. Metastasized cancer cells can be treated with surgery and chemotherapy.
The peritoneum is a thin continuous sheet of tissue, or membrane, that lines the cavities of the abdomen and pelvis and covers the surfaces of the organs found within. It produces a lubricating fluid, called serous fluid, which allows the intestines to move freely over each other. That part which forms the lining of the walls is called the parietal layer, while the part which covers the pelvic and abdominal organs is known as the visceral layer. Between the visceral and parietal peritoneal layers is a space known as the peritoneal cavity. Blood vessels, lymph vessels, and nerves run through the peritoneum, supplying blood to the organs, and tumors that occur in the abdomen tend to spread throughout the peritoneal tissue.
In the abdominal and pelvic cavities there are a large number of intricately arranged organs, and the peritoneum helps keep everything in place. It does this because the visceral layer, which surrounds the organs, is attached by threads to the parietal layer, lining the walls, which keeps the bowels from moving too far out of position. This is especially important in the case of the intestines, which are about 33 feet (about 10 meters) long and very tightly coiled in place. Some organs, such as the kidneys, are located within the abdominal or pelvic cavity but outside the peritoneum, and these are known as retroperitoneal organs.
There is a rich supply of nerves to the parietal peritoneum, making it sensitive to pain. This means that any disease or injury that occurs in it causes pain that is immediately felt in the affected place. The visceral peritoneum is not as well supplied with nerves and pain is usually felt only as a response to its stretching. With visceral pain, it is difficult to pinpoint the source of the injury, especially as the pain is often referred to another area of the body.
Since the peritoneal cavity is potentially large enough, any disease within it is capable of spreading widely. Some cancers originate within the peritoneal cavity, including malignant peritoneal mesothelioma, a rare cancer that arises from the peritoneum. This type of peritoneal cancer is associated with asbestos exposure and some early signs are pain and swelling in the abdomen, weight loss and anemia. Treatment uses a combination of approaches, such as surgery, radiation, and chemotherapy, along with newer, more experimental options. A cure is only possible if the disease is discovered early, while still fairly localized.
It is more common for tumors to originate elsewhere and for cancer cells to spread or metastasize to the peritoneum. There are numerous examples of cancers progressing this way, including those affecting the stomach, breast, ovary and lung. Metastasized cancer cells can be treated with a combination of surgery and chemotherapy to prolong the patient’s life.
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