[Peritoneal effusions : characteristic radiological images (author's transl)].

The early radiological diagnosis of peritoneal effusion (ascites or hemoperitoneum) can be achieved by studying three recesses of the peritoneal cavity : the pelvis and the paracolic gutters. The author describes a method which consists in insufflating the colon in order to obtain a better delineation of the rectum and of the internal limits of the gutters, in accumulating the fluid in each recessus by positioning the patient and in using X-ray parameters suitable for the soft tissues. The recesses are examined separately. The characteristic features of effusion are described. Three different pictures can be found, an attempt is made to define their significance due to the anatomy of the recessus and to the amount of fluid. Such a procedure was performed in 99 patients : 58 were suspected of ascites and 41 of hemoperitoneum. A diagnosis of effusion was made when the characteristic images were recognized in one or several recesses. The results were compared with the findings of laparotomy, needle puncture of paracentesis. The radiological diagnosis of peritoneal effusion was confirmed in 92% of cases. This radiological method is equal value to paracentesis for the diagnosis of hemoperitoneum and of superior value to clinical examination in ascites. The author points out the fact that effusions less than 150 ml were detected in 96% of cases. Since the radiological signs of ascites mentioned in the literature are valid only when about a litre of fluid is present, such methods should be replaced by the above mentioned radiological procedure.