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Surgical anatomy of the retroperitoneal spaces part II: the architecture of the retroperitoneal space.

机译:腹膜后间隙的外科解剖第二部分:腹膜后间隙的结构。

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The extraperitoneal space extends between peritoneum and investing fascia of muscles of anterior, lateral and posterior abdominal and pelvic walls, and circumferentially surrounds the abdominal cavity. The retroperitoneum, which is confined to the posterior and lateral abdominal and pelvic wall, may be divided into three surgicoanatomic zones: centromedial, lateral (right and left), and pelvic. The preperitoneal space is confined to the anterior abdominal wall and the subperitoneal extraperitoneal space to the pelvis. In the extraperitoneal tissue, condensation fascias delineate peri- and parasplanchnic spaces. The former are between organs and condensation fasciae, the latter between this fascia and investing fascia of neighboring muscles of the wall. Thus, perirenal space is encircled by renal fascia, and pararenal is exterior to renal fascia. Similarly for the urinary bladder, paravesical space is between the umbilical prevesical fascia and fascia of the pelvic wall muscles-the prevesical space is its anterior part, between transversalis and umbilical prevesical fascia. For the rectum, the "mesorectum" describes the extraperitoneal tissue bound by the mesorectal condensation fascia, and the pararectal space is between the latter and the muscles of the pelvic wall. Perisplanchnic spaces are closed, except for neurovascular pedicles. Prevesical and pararectal (presacral) and posterior pararenal spaces are in the same anatomical level and communicate. Anterior to the anterior layer of the renal fascia, the anterior interfascial plane (superimposed and fused mesenteries of pancreas, duodenum, and colon) permits communication across the midline. Thus parasplanchnic extraperitoneal spaces of abdomen and pelvis communicate with each other and across the midline.
机译:腹膜外空间在腹膜与前,外侧和后腹壁和骨盆壁的肌肉的筋膜之间延伸,并沿周向围绕腹腔。腹膜后部局限于腹膜后壁,腹壁和骨盆壁,可分为三个上颌解剖区:中央,外侧(右侧和左侧)和骨盆。腹膜前间隙限于腹前壁,腹膜下腹膜间隙限于骨盆。在腹膜外组织中,凝结筋膜划定了周围和内脏间隙。前者位于器官和凝结筋膜之间,后者介于该筋膜和周围壁肌肉的投资筋膜之间。因此,肾筋膜包围肾周空间,肾筋膜外部是肾旁。类似地,对于膀胱而言,膀胱前间隙位于脐前膀胱筋膜和骨盆壁肌肉筋膜之间;膀胱前间隙是其前部,位于横行和脐前膀胱筋膜之间。对于直肠,“肠系膜”描述了由直肠系膜凝结筋膜束缚的腹膜外组织,而直肠旁间隙位于后者和骨盆壁的肌肉之间。除神经血管蒂外,胸骨周围的空间是封闭的。膀胱前和直肠旁(s前)和肾后旁间隙处于相同的解剖水平并相互连通。肾筋膜前层的前部,前筋膜间平面(胰腺,十二指肠和结肠的叠层和融合肠系膜)允许跨中线进行通讯。因此,腹部和骨盆的腹膜下腹膜外间隙彼此连通并且跨过中线。

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