Anterior pararenal space
Updates to Article Attributes
The anterior pararenal space is the portion of the retroperitoneum that lies between the posterior surface of the parietal peritoneum and the anterior reflection of the perirenal fascia.
Gross anatomy
It contains the retroperitoneal portion of the duodenum (D2 and D4(distal D1 to D3), the pancreas and retroperitoneal segments of the ascending and descending colon. It also contains the roots of the small bowel mesentery and transverse mesocolon1.
Boundaries
medially: there is continuity with the contralateral anterior pararenal space although in most cases, fluid will lateralise to the side of pathology
laterally: the compartment is limited as the lateroconal fascia and parietal peritoneum merge
superiorly: fluid may extend to the dome of the diaphragm immediately posterior to the oesophagus and phrenicoesophageal ligament
inferiorly: fluid may extend to the iliac fossa, from there into the pelvis and potentially to the rectus sheath, around the round ligament or ductus deferens and even into the femoral sheath
Radiographic features
There is a paucity of fat within the compartment and therefore, it is difficult to identify on CT or MRI in patients with no additional pathology.
When fluid collects within the anterior pararenal space it becomes easier to identify on CT or MRI. Additionally, because the perirenal fascia is bilaminated, fluid in the compartment can dissect between the anterior and posterior fascia and sit behind the kidney.
Additionally, fluid can dissect along ligaments and mesenteries to lie in the subperitoneal space, e.g. gastrosplenic ligament, transverse mesocolon and greater omentum.
-<p>The <strong>anterior pararenal space</strong> is the portion of the <a href="/articles/retroperitoneum">retroperitoneum</a> that lies between the posterior surface of the parietal <a href="/articles/peritoneum">peritoneum</a> and the anterior reflection of the <a href="/articles/perirenal-fascia">perirenal fascia</a>.</p><h4>Gross anatomy</h4><p>It contains the <a href="/articles/duodenum">duodenum</a> (D2 and D4), <a href="/articles/pancreas">pancreas</a> and retroperitoneal segments of the <a href="/articles/ascending-colon">ascending</a> and <a href="/articles/descending-colon">descending colon</a>. It also contains the roots of the <a href="/articles/small-bowel-mesentery">small bowel mesentery</a> and <a href="/articles/transverse-mesocolon">transverse mesocolon</a>.</p><h5>Boundaries</h5><ul>-<li>-<strong>medially: </strong>there is continuity with the contralateral anterior pararenal space although in most cases, fluid will lateralise to the side of pathology</li>-<li>-<strong>laterally: </strong>the compartment is limited as the <a href="/articles/lateroconal-fascia">lateroconal fascia</a> and parietal peritoneum merge</li>-<li>-<strong>superiorly:</strong> fluid may extend to the dome of the diaphragm immediately posterior to the <a href="/articles/oesophagus">oesophagus</a> and phrenicoesophageal ligament</li>-<li>-<strong>inferiorly:</strong> fluid may extend to the iliac fossa, from there into the pelvis and potentially to the <a href="/articles/rectus-sheath">rectus sheath</a>, around the <a href="/articles/round-ligament">round ligament</a> or <a href="/articles/vas-deferens">ductus deferens</a> and even into the <a href="/articles/femoral-sheath">femoral sheath</a>-</li>- +<p>The <strong>anterior pararenal space</strong> is the portion of the <a href="/articles/retroperitoneum">retroperitoneum</a> that lies between the posterior surface of the parietal <a href="/articles/peritoneum">peritoneum</a> and the anterior reflection of the <a href="/articles/perirenal-fascia">perirenal fascia</a>.</p><h4>Gross anatomy</h4><p>It contains the retroperitoneal portion of the <a href="/articles/duodenum">duodenum</a> (distal D1 to D3), the <a href="/articles/pancreas">pancreas</a> and retroperitoneal segments of the <a href="/articles/ascending-colon">ascending</a> and <a href="/articles/descending-colon">descending colon</a>. It also contains the roots of the <a href="/articles/small-bowel-mesentery">small bowel mesentery</a> and <a href="/articles/transverse-mesocolon">transverse mesocolon</a><sup>1</sup>.</p><h5>Boundaries</h5><ul>
- +<li><p><strong>medially: </strong>there is continuity with the contralateral anterior pararenal space although in most cases, fluid will lateralise to the side of pathology</p></li>
- +<li><p><strong>laterally: </strong>the compartment is limited as the <a href="/articles/lateroconal-fascia">lateroconal fascia</a> and parietal peritoneum merge</p></li>
- +<li><p><strong>superiorly:</strong> fluid may extend to the dome of the diaphragm immediately posterior to the <a href="/articles/oesophagus">oesophagus</a> and phrenicoesophageal ligament</p></li>
- +<li><p><strong>inferiorly:</strong> fluid may extend to the iliac fossa, from there into the pelvis and potentially to the <a href="/articles/rectus-sheath">rectus sheath</a>, around the <a href="/articles/round-ligament">round ligament</a> or <a href="/articles/vas-deferens">ductus deferens</a> and even into the <a href="/articles/femoral-sheath">femoral sheath</a></p></li>
References changed:
- 1. Susan Standring. Gray's Anatomy. (2020) ISBN: 9780702077050 - <a href="http://books.google.com/books?vid=ISBN9780702077050">Google Books</a>
- 2. Standring S (editor). Gray's Anatomy (39th edition). Churchill Livingstone. (2011) ISBN:0443066841. <a href="http://books.google.com/books?vid=ISBN0443066841">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0443066841">Find it at Amazon</a><span class="ref_v3"></span>
- 3. Schuenke M, Schulte E, Schumacher U et-al. Thieme Atlas of Anatomy. Thieme Publishing Group. (2006) ISBN:3131420812. <a href="http://books.google.com/books?vid=ISBN3131420812">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/3131420812">Find it at Amazon</a><span class="ref_v3"></span>
- 1. Standring S (editor). Gray's Anatomy (39th edition). Churchill Livingstone. (2011) ISBN:0443066841. <a href="http://books.google.com/books?vid=ISBN0443066841">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0443066841">Find it at Amazon</a><span class="ref_v3"></span>
- 2. Schuenke M, Schulte E, Schumacher U et-al. Thieme Atlas of Anatomy. Thieme Publishing Group. (2006) ISBN:3131420812. <a href="http://books.google.com/books?vid=ISBN3131420812">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/3131420812">Find it at Amazon</a><span class="ref_v3"></span>