To outline the anatomy of the retroperitoneal space
To describe the leading causes of retroperitoneal necrotizing/gas-forming diseases
Role of the radiologist
Retroperitoneum is the portion of abdomen and pelvis located outside the peritoneal cavity and bounded anteriorly by parietal peritoneal fold (Fig. 1).
1.1 Abdominal retroperitoneal space
Meyer’s and colleagues tricompartmental theory divides the abdominal retroperitoneum into the following spaces: (Fig. 2):
- Anterior pararenal space (APS)
- Perirenal space (PS)
- Posterior pararenal space (PPS)
Subsequent research updated the tricompartmental theory through the demonstration of multi-laminated fasciae that create communications routes and spreading ways for pathological processes of the abdomen (Fig. 3).
Findings and procedure details
Retroperitoneal diseases are typically an emergency condition that require an early diagnosis to ensure an optimal management.
As clinical symptoms are frequently vague and mild,
and local examination is not easily accessible by clinicians,
an early diagnosis may be hard.
Affected patients may show critical predisposing factors (e.g.
chronic renal failure) that decrease the prognosis in terms of overall survival.
Retroperitoneal diseases may manifest in form of fluid effusions,
inflammatory collections and pneumoretroperitoneum; in particular,
retroperitoneal necroses can be life-threatening complications of...
Identification of pathologic involvement of retroperitoneum requires an optimal knowledge of its complex anatomy.
CT-imaging permits to evaluate the presence of pneumoretroperitoneum and associated findings of fluid and inflammatory collections and their extension.
the radiologist give an important support to clinicians in the establishment of the diagnosis and the better management of the underlying causes.
Meyers' Dynamic Radiology of the Abdomen Normal and Pathologic Anatomy.
Frias Vilaça A.,
The anatomical compartments and their connections as demonstrated by ectopic air.
Insights Imaging 2013; 4(6): 759–772.
Tan CH,Vikram R,Boonsirikamchai P,Faria SC,Charnsangavej C,Bhosale PR.
Pathways of extrapelvic spread of pelvic disease: imaging findings.
Radiographics 2011; 31(1):117–133.
Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis...