Subperitoneal Spread of Intra-Abdominal Disease

Abstract

The formation of the coelomic cavity during fetal life divides the abdomen into two major parts—the peritoneal cavity and the retroperitoneum. Classically, the retroperitoneum is further subdivided by its fascial planes into three components: the perirenal space containing the kidneys and the adrenal glands; the anterior pararenal space containing the pancreas, the duodenum, and the ascending and descending colon; and the posterior pararenal space deep to the transversalis fascia continuing around the flank [1,2]. Caudad to the perirenal space the anterior and posterior pararenal spaces become confluent. These divisions of the retroperitoneum are extremely helpful for understanding the spread and confinement of disease within these spaces. This concept is also of importance in establishing the differential diagnosis of a pathologic process when the abnormality is identified within a specific space (Figs. 5-1, 5-2).