Retroperitoneal Hematoma
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The retroperitoneal space (retroperitoneum) is the
anatomical space {{set index article In anatomy, a spatium or anatomic space is a space (cavity or gap). Anatomic spaces are often landmarks to find other important structures. When they fill with gases (such as air) or liquids (such as blood) in pathological ways, ...
(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 The mesentery is an organ that attaches the intestines to the posterior abdominal wall in humans 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 ...
in the abdominal cavity and that lie between the parietal peritoneum and abdominal wall are classified as retroperitoneal. 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: *Perirenal (or perinephric) space *Anterior pararenal (or paranephric) space *Posterior pararenal (or paranephric) space


Retroperitoneal structures

Structures that lie behind the peritoneum are termed "retroperitoneal". Organs that were once suspended within the abdominal cavity by
mesentery The mesentery is an organ that attaches the intestines to the posterior abdominal wall in humans 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 ...
but migrated posterior to the peritoneum during the course of
embryogenesis An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sperm ...
to become retroperitoneal are considered to be secondarily retroperitoneal organs. * Primarily retroperitoneal, meaning the structures were retroperitoneal during the entirety of development: ** urinary *** adrenal glands *** kidneys *** ureter ** circulatory *** aorta *** inferior vena cava ** digestive *** anal canal * Secondarily retroperitoneal, meaning the structures initially were suspended in
mesentery The mesentery is an organ that attaches the intestines to the posterior abdominal wall in humans 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 ...
and later migrated behind the peritoneum during development ** the
duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
, except for the proximal first segment, which is intraperitoneal ** ascending and descending portions of the colon (but not the transverse colon, sigmoid and the cecum) ** pancreas, except for the tail, which is intraperitoneal


Subdivisions

;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: * Adrenal gland * Kidney * Renal vessels * Perirenal fat, which is also called the "adipose capsule of the kidney" and may be regarded as being part of the renal capsuleUniversity of Michigan
- Lab Manual - Kidneys & Retroperitoneum ;Anterior pararenal space Bounded by the posterior layer of peritoneum and the anterior leaf of the renal fascia. It contains the following structures: * Pancreas * Ascending and descending colon *
Duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
;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"), and is also called the "paranephric body", or "pararenal fat body".


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. * Retroperitoneal fibrosis * Retroperitoneal lymph node dissection 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. Examples of tumors include ** Primary retroperitoneal carcinoma ** Pseudomyxoma peritonei **Examples of sarcomas include: ** Soft-tissue sarcoma *** liposarcoma *** leiomyosarcoma *** Undifferentiated pleomorphic sarcoma, a clinically distinct sarcoma of the area


See also

* Intraperitoneal


References

{{Authority control Abdomen