Peritoneum and Retroperitoneum

Peritoneum and Retroperitoneum


INTRODUCTION


List of retroperitoneal organs


1.    Kidneys, ureters


2.    Uterus, fallopian tubes, prostate


3.    Pancreas


4.    Aorta, IVC


5.    Esophagus (thoracic), duodenum (Second, third, and fourth)


6.    Ascending and descending colon, rectum (middle one-third)


7.    Adrenal glands


List of intraperitoneal organs


1.    Liver, spleen


2.    Stomach, duodenum (first part)


3.    Jejunum, ileum


4.    Cecum, appendix


5.    Transverse and sigmoid colon, rectum (upper one-third)


6.    Ovaries


Urinary bladder, lower one-third rectum, and distal ureters are infra/subperitoneal in nature.


Peritoneal cavity spaces


Small bowel mesentery is a specialized peritoneal fold extending from the second lumbar vertebra to the right iliac fossa containing blood vessels, nerves, lymph nodes, and fat. It connects jejunum and ileum to posterior abdominal wall and is difficult to appreciate if ascites is not present (Table 12.1).


Omentum: Specialized peritoneal folds.


Lesser omentum: Connects the lesser curvature of the stomach and proximal duodenum with the liver.


Table 12.1 Illustrating various peritoneal cavity spaces






















Subphrenic space


Bilateral, inferior to diaphragm


Subhepatic space


Inferior to liver; anterior and posterior


Posterior subhepatic space is called Morrison’s space


Lesser sac (Omental bursa)


Between stomach and pancreas


Paracolic gutters


Bilateral; along ascending and descending colon.


Right paracolic gutter is larger than left, communicates freely with the right subphrenic space


Phrenicocolic ligament partially limits the connection between left paracolic gutter and left subphrenic space


Pelvic


Females—b/w uterus and rectum; also known as rectouterine pouch or POD (Pouch of Douglas)


Males—recto vesical pouch; b/w rectum and urinary bladder


Anterior cul-de-sac


Urinary bladder and uterus


Greater omentum: Descends from the greater curvature of the stomach.


Foramen of Winslow (Epiploic foramen): Passage between greater and lesser sac.


Retroperitoneal spaces


1.    Posterior pararenal space


2.    Anterior pararenal space


3.    Perirenal space


Ascites (Figure 12.1)

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Nov 6, 2018 | Posted by in ULTRASONOGRAPHY | Comments Off on Peritoneum and Retroperitoneum
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