The Peritoneum: Beyond the Tissue - A Review

Area of Science:

• Anatomy and Physiology
• Developmental Biology
• Cell Biology

Background:

• The peritoneum is frequently underestimated in medical literature, often simplified as mere serous tissue surrounding the gut.
• Existing research on peritoneal morphology and physiology is often narrowly focused on Continuous Ambulatory Peritoneal Dialysis (CAPD).

Purpose of the Study:

• To review and analyze recent evidence on the peritoneum's morphology, embryology, and physiology.
• To challenge the traditional, simplistic view of the peritoneum.

Main Methods:

• A comprehensive literature review was conducted using PubMed and MEDLINE.
• Included original papers and reviews on the peritoneum, peritoneal cavity, fluid, and mesothelial cells, with no publication date restrictions (n=72).

Main Results:

• The peritoneum develops concurrently with the primitive gut, suggesting the peritoneal cavity and mesenteries are integral parts.
• Mesothelial cells exhibit complex ultrastructure with intercellular junctions and microvilli, supporting diverse functions.
• Identified functions include selective transport, barrier functions, immune modulation, tissue repair, and epithelial-mesenchymal transition capacity.

Conclusions:

• Emerging evidence indicates the peritoneum is a complex anatomical and physiological structure, not just a simple serous membrane.
• A revised conceptualization of the peritoneum is needed, integrating new findings on its anatomy, histology, and physiology.
• Further research is crucial to uncover the clinical relevance of the peritoneum's complex functions.