Retroperitoneal space

Last updated
Retroperitoneal space
Retroperitoneal spaces.png
Horizontal plane through the kidneys, showing subdivisions of the retroperitoneal space. The anterior and posterior pararenal spaces have been exaggerated to provide representation of their relation to other retroperitoneal structures.
Gray1120.png
Human kidneys viewed from behind with spine removed
Details
Identifiers
Latin spatium retroperitoneale
MeSH D012187
TA98 A10.1.01.002
TA2 3814
FMA 15080
Anatomical terminology

The retroperitoneal space (retroperitoneum) is the anatomical space (sometimes a potential space) behind (retro) the peritoneum. It has no specific delineating anatomical structures. Organs are retroperitoneal if they have peritoneum on their anterior side only. Structures that are not suspended by mesentery in the abdominal cavity and that lie between the parietal peritoneum and abdominal wall are classified as retroperitoneal. [1]

Contents

This is different from organs that are not retroperitoneal, which have peritoneum on their posterior side and are suspended by mesentery in the abdominal cavity.

The retroperitoneum can be further subdivided into the following: [2]

Retroperitoneal structures

Structures that lie behind the peritoneum are termed "retroperitoneal". Organs that were once suspended within the abdominal cavity by mesentery but migrated posterior to the peritoneum during the course of embryogenesis to become retroperitoneal are considered to be secondarily retroperitoneal organs.

Subdivisions

Transverse section, showing the relations of the capsule of the kidney. (Peritoneum is labeled at center right.) Gray1126.png
Transverse section, showing the relations of the capsule of the kidney. (Peritoneum is labeled at center right.)
Sagittal section through posterior abdominal wall, showing the relations of the capsule of the kidney (pararenal fat labeled as paranephric body center left) Gray1125.png
Sagittal section through posterior abdominal wall, showing the relations of the capsule of the kidney (pararenal fat labeled as paranephric body center left)
Perirenal space

It is also called the perinephric space. Bounded by the anterior and posterior leaves of the renal fascia. It contains the following structures:

Anterior pararenal space

Bounded by the posterior layer of peritoneum and the anterior leaf of the renal fascia. It contains the following structures:

Posterior pararenal space

Bounded by the posterior leaf of the renal fascia and the muscles of the posterior abdominal wall. It contains only fat ("pararenal fat" also known as "pararenal fat body", "paranephric body", or "paranephric fat").

Pararenal fat is a fatty layer situated posterior to the renal compartment, and extending inferiorly into the iliac fossa. [7] It is situated posterior to the posterior aspect of renal fascia, and anterior to the aponeuroses of the retrorenal muscles. It is plentiful in the dihedral angle of the iliopsoas muscle and the quadratus lumborum muscle, filling the lumbar fossa posterior and inferior to the kidney. [8]

Clinical significance

Bleeding from a blood vessel or structure in the retroperitoneal such as the aorta or inferior vena cava into the retroperitoneal space can lead to a retroperitoneal hemorrhage.

It is also possible to have a neoplasm in this area, more commonly a metastasis; or very rarely a primary neoplasm. The most common type is a sarcoma followed by lymphoma, extragonadal germ cell tumor, and gastrointestinal stromal tumor/GIST. [9] Examples of tumors include

See also

Related Research Articles

<span class="mw-page-title-main">Kidney</span> Organ that filters blood and produces urine

In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retroperitoneal space, and in adult humans are about 12 centimetres in length. They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder.

<span class="mw-page-title-main">Peritoneum</span> Serous membrane that forms lining of abdominal cavity or coelom

The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue. This peritoneal lining of the cavity supports many of the abdominal organs and serves as a conduit for their blood vessels, lymphatic vessels, and nerves.

Articles related to anatomy include:

<span class="mw-page-title-main">Mesentery</span> Contiguous fold of tissues that supports the intestines

The mesentery is an organ that attaches the intestines to the posterior abdominal wall and is formed by the double fold of peritoneum. It helps in storing fat and allowing blood vessels, lymphatics, and nerves to supply the intestines, among other functions.

<span class="mw-page-title-main">Renal capsule</span> Layer surrounding kidney

The renal capsule is a tough fibrous layer surrounding the kidney and covered in a layer of perirenal fat known as the adipose capsule of kidney. The adipose capsule is sometimes included in the structure of the renal capsule. It provides some protection from trauma and damage. The renal capsule is surrounded by the renal fascia. Overlying the renal fascia and between this and the transverse fascia is a region of pararenal fat.

<span class="mw-page-title-main">Abdominal aorta</span> Largest artery in the abdomen

In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta.

<span class="mw-page-title-main">Renal vein</span> Short thick veins which return blood from the kidneys to the vena cava

The renal veins in the renal circulation, are large-calibre veins that drain blood filtered by the kidneys into the inferior vena cava. There is one renal vein draining each kidney. Each renal vein is formed by the convergence of the interlobar veins of one kidney.

<span class="mw-page-title-main">Inferior mesenteric artery</span>

In human anatomy, the inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The regions supplied by the IMA are the descending colon, the sigmoid colon, and part of the rectum.

<span class="mw-page-title-main">Abdomen</span> Part of the body between the chest and pelvis

The abdomen is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax.

<span class="mw-page-title-main">Abdominal wall</span> Boundary of abdominal cavity

In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls.

<span class="mw-page-title-main">Greater omentum</span> Fat sheath under abdominal wall

The greater omentum is a large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and doubles back to ascend to the transverse colon before reaching to the posterior abdominal wall. The greater omentum is larger than the lesser omentum, which hangs down from the liver to the lesser curvature. The common anatomical term "epiploic" derives from "epiploon", from the Greek epipleein, meaning to float or sail on, since the greater omentum appears to float on the surface of the intestines. It is the first structure observed when the abdominal cavity is opened anteriorly.

<span class="mw-page-title-main">Fascia of Colles</span>

The membranous layer of the superficial fascia of the perineum is the deeper layer of the superficial perineal fascia. It is thin, aponeurotic in structure, and of considerable strength, serving to bind down the muscles of the root of the penis. Colles' fascia emerges from the perineal membrane, which divides the base of the penis from the prostate. Colles' fascia emerges from the inferior side of the perineal membrane and continues along the ventral (inferior) penis without covering the scrotum. It separates the skin and subcutaneous fat from the superficial perineal pouch.

<span class="mw-page-title-main">Superficial perineal pouch</span>

The superficial perineal pouch is a compartment of the perineum.

<span class="mw-page-title-main">Retropubic space</span>

Retropubic space is a potential avascular space located between the pubic symphysis and the urinary bladder. The retropubic space is a preperitoneal space, located behind the transversalis fascia and in front of peritoneum.

<span class="mw-page-title-main">Renal fascia</span> Tissue

The renal fascia is a dense, elastic connective tissue envelope enclosing the kidney and adrenal gland, together with the layer of perirenal fat surrounding these two.

<span class="mw-page-title-main">Carl Toldt</span> Austrian anatomist (1840–1920)

Carl Toldt, sometimes Karl Toldt was an Austrian anatomist who was a native of Bruneck, South Tyrol.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Wunderlich syndrome</span> Medical condition

Wunderlich syndrome can refer to one of several conditions. One condition called Wunderlich syndrome is spontaneous, nontraumatic kidney bleeding confined to the subcapsular and perirenal space. It may be the first manifestation of a renal angiomyolipoma (AML), or the rupture of a renal artery or intraparenchymal aneurysm. The renal condition should not be confused with other conditions which are Mullerian duct anomalies, such as Herlyn-Werner-Wunderlich syndrome. Some sources refer to double uters-hemivagina-renal agenesis as simply Wunderlich syndrome, but Herlyn-Werner-Wunderlich is a better term to distinguish the two.

Extraperitoneal fascia is a fascial plane - consisting mostly of loose areolar connective tissue - situated between the fascial linings of the walls of the abdominal and pelvic cavities externally, and the parietal peritoneum internally. Its quality and quantity is varies considerably. It occupies the extraperitoneal space.

The development of the digestive system in the human embryo concerns the epithelium of the digestive system and the parenchyma of its derivatives, which originate from the endoderm. Connective tissue, muscular components, and peritoneal components originate in the mesoderm. Different regions of the gut tube such as the esophagus, stomach, duodenum, etc. are specified by a retinoic acid gradient that causes transcription factors unique to each region to be expressed. Differentiation of the gut and its derivatives depends upon reciprocal interactions between the gut endoderm and its surrounding mesoderm. Hox genes in the mesoderm are induced by a Hedgehog signaling pathway secreted by gut endoderm and regulate the craniocaudal organization of the gut and its derivatives. The gut system extends from the oropharyngeal membrane to the cloacal membrane and is divided into the foregut, midgut, and hindgut.

References

  1. Gray's Anatomy for Students, 2nd Ed. 2010. Pg. 251
  2. Ryan, Stephanie; McNicholas, Michelle; Eustace, Stephen (2004). Anatomy for Diagnostic Imaging. Sydney: Saunders. p. 191. ISBN   978-0-7020-2620-1.
  3. Kyung Won Chung (2005). Gross Anatomy (Board Review). Hagerstown, MD: Lippincott Williams & Wilkins. p. 256. ISBN   0-7817-5309-0.
  4. K. L. Moore; A. F. Dalley; A. M. R. Agur (2005). Clinically Oriented Anatomy . Hagerstown, MD: Lippincott Williams & Wilkins. pp.  1209. ISBN   0-7817-3639-0.
  5. 1 2 "Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2023-11-10.
  6. University of Michigan - Lab Manual - Kidneys & Retroperitoneum
  7. "Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2023-11-10.
  8. "corps adipeux pararénal - Dictionnaire médical de l'Académie de Médecine". www.academie-medecine.fr. Retrieved 2023-11-10.
  9. Raval, Bharat; Pollock, Raphael E.; Guadagnolo, Ashleigh; Patel, Shreyaskumar (1 January 2012). "Chapter 23 - Primary Retroperitoneal Tumors". Oncologic Imaging: A Multidisciplinary Approach. W.B. Saunders. pp. 403–421.