Malignant ascites: sonographic signs of peritoneal carcinomatosis

This study was performed in 65 patients with cytologically proved malignant ascites to describe and classify direct and indirect sonographic signs of peritoneal carcinomatosis. Abdominal sonography revealed tumour-associated abnormalities which account for malignant ascites in 60 cases (92%). This includes visualisation of peritoneal metastases (n = 16, 25%); matting together of bowel loops (17, 26%); distribution of fluid (19, 29%); echoes within the fluid space (3, 5%); omental matting (8, 12%); associated masses (21, 32%); lymphoadenopathy (31, 48%); and hepatic metastases (26, 40%). Sonography enables the physician to demonstrate direct and indirect signs of peritoneal carcinomatosis in almost all tumour patients with ascites and is therefore useful in determining whether the cause of ascites is malignant or benign disease.