The Extraperitoneal Spaces: Normal and Pathologic Anatomy

  • Morton A. Meyers
  • Chusilp Charnsangavej
  • Michael Oliphant


The extraperitoneal portion of the abdomen has always been considered a difficult region in terms of anatomic definitions, clinical evaluation, and radiologic diagnosis. Anatomically, it has been vaguely considered as occupying the posterior half of the abdomen, without well-defined fascial boundaries. Clinically, it is commonly recognized that extraperitoneal effusions are difficult to diagnose. The area is not accessible to the bedside modalities of auscultation, palpation, or percussion. Symptoms and signs may be obscure, delayed, nonspecific, or misleading.


Psoas Muscle Pararenal Space Transversalis Fascia Perirenal Space Renal Fascia 


  1. 1.
    Meyer HI: The reaction of retroperitoneal tissue to infection. Ann Surg 1934; 99:246–250.PubMedGoogle Scholar
  2. 2.
    Stevenson EO, Ozeran RS: Retroperitoneal space abscesses. Surg Gynecol Obstet 1969; 128:1202–1208.PubMedGoogle Scholar
  3. 3.
    Altemeier WA, Alexander JW:: Retroperitoneal abscess. Arch Surg 1961; 83:512–524.PubMedGoogle Scholar
  4. 4.
    Elkin M, Cohen G: Diagnostic value of the psoas shadow. Clin Radiol 1962; 13:210–217.Google Scholar
  5. 5.
    Williams SM, Harned RK, Hultman SA et al: The psoas sign: A reevaluation. Radiographics 1985; 5:525–536.Google Scholar
  6. 6.
    Editorial: Periureteric fibrosis. Lancet 1957; 2:780–781.Google Scholar
  7. 7.
    Love L, Meyers MA, Churchill RJ et al: Computed tomography of extraperitoneal spaces. AJR 1981; 136:781–789.PubMedGoogle Scholar
  8. 8.
    Meyers MA: Acute extraperitoneal infection. Semin Roentgenol 1973; 8:445–464.PubMedGoogle Scholar
  9. 9.
    Meyers MA: Radiologic features of the spread and localization of extraperitoneal gas and their relationship to its source: An anatomical approach. Radiology 1974; 111:17–26.PubMedGoogle Scholar
  10. 10.
    Meyers MA: Uriniferous perirenal pseudocyst: New observations. Radiology 1975; 117:539–545.PubMedGoogle Scholar
  11. 11.
    Meyers MA, Whalen JP, Evans JA: Diagnosis of perirenal and subcapsular masses: Anatomic-radiologic correlation. AJR Rad Ther Nucl Med 1974; 121:523–538.Google Scholar
  12. 12.
    Meyers MA, Whalen JP, Peelle K et al: Radiologic features of extraperitoneal effusions: An anatomic approach. Radiology 1972; 104:249–257.PubMedGoogle Scholar
  13. 13.
    Meyers MA: Diseases of the Adrenal Glands: Radiologic Diagnosis with Emphasis on the Use of Presacral Retroperitoneal Pneumography. Charles C Thomas, Springfield, 1963, pp 11–15, 20.Google Scholar
  14. 14.
    Barbaric Z: Renal fascia in urinary tract diseases. Radiology 1976; 118:561–565.PubMedGoogle Scholar
  15. 15.
    Kochkodan EJ, Haggar AM: Visualization of the renal fascia: A normal finding in urography. AJR 1983; 140:1243–1244.PubMedGoogle Scholar
  16. 16.
    Whalen JP, Ziter FMH Jr: Visualization of the renal fascia: A new sign in localization of abdominal masses. Radiology 1967; 80:861–863.Google Scholar
  17. 17.
    Feldberg MAM: Computed Tomography of the Retroperitoneum: An Anatomical and Pathological Atlas with Emphasis on the Fascial Planes. Martinus Nijhoff, Boston, 1983.Google Scholar
  18. 18.
    Meyers MA: Dynamic Radiology of the Abdomen: Normal and Pathologic Anatomy, 2nd ed. Springer, New York, 1982.Google Scholar
  19. 19.
    Parienty RA, Pradel J, Picard JD et al: Visibility and thickening of the renal fascia on computed tomograms. Radiology 1981; 139:119–124.PubMedGoogle Scholar
  20. 20.
    Zuckerkandl E: Beitrage zur Anatomie des Menschlichen Korpers. Ueber den Fixationsapparat der Nieren. Med Jahr 1883; 13:59–67.Google Scholar
  21. 21.
    Gerota D: Beitraege zur Kenntnis des Befestigungsapparates der Niere. Arch Anat Entwicklungsgesch, Leipzig, 1895, pp 265–286.Google Scholar
  22. 22.
    Chesbrough RM, Burkhard TK, Martinez AJ et al: Gerota versus Zuckerkandl: The renal fascia revisited. Radiology 1989; 173:845–846.PubMedGoogle Scholar
  23. 23.
    Meyers MA, Oliphant M, Berne AS et al: The peritoneal ligaments and mesenteries: Pathways of intraabdominal spread of disease. Annual oration. Radiology 1987; 163:3–604.Google Scholar
  24. 24.
    Oliphant M, Berne AS, Meyers MA: Spread of disease via the subperitoneal space: The small bowel mesentery. Abdom Imaging 1993; 18:109–116.PubMedGoogle Scholar
  25. 25.
    Congdon ED, Edson JN: The cone of renal fascia in the adult white male. Anat Rec 1941; 80:289–313.Google Scholar
  26. 26.
    Mitchell GAG: The renal fascia. Br J Surg 1950; 37:257.PubMedGoogle Scholar
  27. 27.
    Somogyi J, Cohen WN, Omar MM et al: Communication of right and left perirenal spaces demonstrated by computed tomography. J Comput Assist Tomogr 1979; 3:270–273.PubMedGoogle Scholar
  28. 28.
    Martin CP: Anatomical notes: A note on the renal fascia. J Anat 1942; 77:101–103.PubMedGoogle Scholar
  29. 29.
    Kneeland JB, Auh YH, Rubenstein WA et al: Perirenal spaces: CT evidence for communication across the midline. Radiology 1987; 164:657–664.PubMedGoogle Scholar
  30. 30.
    Mindell HJ, Mastromatteo JF, Dickey KW et al: Anatomic communications between the three retroperitoneal spaces: Determination by CT-guided injections of contrast material in cadavers. AJR 1995; 164:1173–1178.PubMedGoogle Scholar
  31. 31.
    Raptopoulos V, Touliopoulos P, Lei QF et al: Medial border of the perirenal space: CT and anatomic correlation. Radiology 1997; 205:777–784.PubMedGoogle Scholar
  32. 32.
    Dodds WJ, Darweesh RMA, Lawson TL et al: The retroperitoneal spaces revisited. AJR 1986; 147:1155–1161.PubMedGoogle Scholar
  33. 33.
    Hureau J, Pradel J, Agossou-Voyeme AK et al: Les espaces interpariéto-péritoneaux postérieurs ou espaces rétropéritonéaux: Anatomie tomodensitometrique normale. J Radiol 1991; 72:101–106.PubMedGoogle Scholar
  34. 34.
    Hureau J, Pradel J, Agossou-Voyeme AK et al: Les espaces interpariéto-péritoneaux postérieursou espaces rétroperitone´aux: Anatomie tomodensitometrique pathologique. J Radiol 1991; 72:205–227.PubMedGoogle Scholar
  35. 35.
    Molmenti EP, Balfe DM, Kanterman RY et al: Anatomy of the retroperitoneum: Observations of the distribution of pathologic fluid collections. Radiology 1996; 200:95–103.PubMedGoogle Scholar
  36. 36.
    Aizenstein RI, Wilbur AC, O’Neil HK: Interfascial and perinephric pathways in the spread of retroperitoneal disease: Refined concepts based on CT observations. AJR 1997; 168:639–643.PubMedGoogle Scholar
  37. 37.
    Lim JH, Yoon Y, Lee SW et al: Superior aspect of the perirenal space: Anatomy and pathological correlation. Clin Radiol 1988; 39:368–372.PubMedGoogle Scholar
  38. 38.
    Lim JH, Auh YH, Suh SJ et al: Right perirenal space: Computed tomography evidence of communication between the bare area of the liver. Clin Imag 1990; 14:239–244.Google Scholar
  39. 39.
    Kim KW, Auh YH, Chi HS et al: CT of retroperitoneal extension of hepatoma mimicking adrenal tumor. J Comput Assist Tomography 1993; 17:599–602.Google Scholar
  40. 40.
    Patten RM, Spear RP, Vincent LM et al: Traumatic laceration of the liver limited to the bare area: CT findings in 25 patients. AJR 1993; 160:1019–1022.PubMedGoogle Scholar
  41. 41.
    Bechtold RE, Dyer RB, Zagoria RJ et al: The perirenal space: Relationship of pathologic processes to normal retroperitoneal anatomy. RadioGraphics 1996; 16:841–854.PubMedGoogle Scholar
  42. 42.
    Tandon N, Karak PK, Mukhopadhyay S et al: Amoebic liver abscess: Rupture into retroperitoneum. Gastrointest Radiol 1991; 16:240–242.PubMedGoogle Scholar
  43. 43.
    Raptopoulos V, Lei QF, Touliopoulos P et al: Why perirenal disease does not extend into the pelvis: The importance of closure of the cone of renal fasciae. AJR 1995; 164:1179–1184.PubMedGoogle Scholar
  44. 44.
    Southam AH: Fixation of the kidney. Q J Med 1923; 16:283–308.Google Scholar
  45. 45.
    Parienty RA, Pradel J: Radiological evaluation of the peri- and pararenal spaces by computed tomography. Crit Rev Diagn Imaging 1983; 20:1–26.PubMedGoogle Scholar
  46. 46.
    Nicholson RL: Abnormalities of the perinephric fascia and fat in pancreatitis. Radiology 1981; 139:125–127.PubMedGoogle Scholar
  47. 47.
    Chintapalli K, Lawson TL, Foley WD et al: Renal fascial thickening in pancreatitis. J Comput Assist Tomogr 1982; 6:983–986.PubMedGoogle Scholar
  48. 48.
    Hadar H, Meiraz D: Thickened renal fascia: A sign of retroperitoneal pathology. J Comput Assist Tomogr 1981; 5:193–198.Google Scholar
  49. 49.
    Jeffrey RB, Federle MP, Crass RA: Computed tomography of pancreatic trauma. Radiology 1983; 147:491–494.PubMedGoogle Scholar
  50. 50.
    Sutton CS, Haaga JR: CT evaluation of limited splenic trauma. J Comput Assist Tomogr 1987; 11:167–169.PubMedGoogle Scholar
  51. 51.
    Feldberg MAM, Hendriks MJ, van Waes P et al: Pancreatic lesions and transfascial perirenal spread: Computed tomographic demonstration. Gastrointest Radiol 1987; 12:121–127.PubMedGoogle Scholar
  52. 52.
    Rubenstein WA, Auh YH, Zirinsky K et al: Posterior peritoneal recesses: Assessment using CT. Radiology 1985; 156:461–468.PubMedGoogle Scholar
  53. 53.
    William PL, Warwick R (eds): Gray’s Anatomy, 36th ed. Churchill Livingstone, Edinburgh, 1980.Google Scholar
  54. 54.
    Saunders BP, Phillips RKS, Williams CB: Intraoperative measurement of colonic anatomy and attachments with relevance to colonoscopy. Br J Surg 1995; 82:1491–1493.PubMedGoogle Scholar
  55. 55.
    Raptopoulos V, Kleinman PK, Marks S Jr et al: Renal fascial pathway: Posterior extension of pancreatic effusions within the anterior pararenal space. Radiology 1986; 158:367–374.PubMedGoogle Scholar
  56. 56.
    Hopper KD, Sherman JL, Juethke J et al: The retrorenal colon in the supine and prone patient. Radiology 1987; 162:443–446.PubMedGoogle Scholar
  57. 57.
    Love L, Demos TC, Posniak H: CT of retrorenal fluid collections. AJR 1985; 145:87–91.PubMedGoogle Scholar
  58. 58.
    Sherman JL, Hopper KD, Greene AJ et al: The retrorenal colon on computed tomography: A normal variant. J Comput Assist Tomogr 1985; 9:339–341.PubMedGoogle Scholar
  59. 59.
    Hadar H, Gadoth N: Positional relations of colon and kidney determined by perirenal fat. AJR 1984; 143:773–776.PubMedGoogle Scholar
  60. 60.
    Kunin M: Bridging septa of the perinephric space: Anatomic, pathologic, and diagnostic considerations. Radiology 1986; 158:361–365.PubMedGoogle Scholar
  61. 61.
    Feuerstein IM, Zeman RK, Jatte MH et al: Perirenal cobwebs: The expanding CT differential diagnosis. J Comput Assist Tomogr 1984; 8:1128–1130.PubMedGoogle Scholar
  62. 62.
    McLennan BL, Lee JKT, Peterson RR: Anatomy of the perirenal area. Radiology 1986; 158:555–557.Google Scholar
  63. 63.
    Winfield AC, Gerlock AJJL, Shaff MI: Perirenal cobwebs: A CT sign of renal vein thrombosis. J Comput Assist Tomogr 1981; 5:705–708.PubMedGoogle Scholar
  64. 64.
    Skarby HG: Beitraege zur Diagnostik der Paranephritiden mit besonderer Berucksichtigung des Roentgenverfahrens. Acta Radiol Suppl 1946; 62:1–165.Google Scholar
  65. 65.
    Whalen JP, Berne AS, Riemenschneider PA: The extraperitoneal perivisceral fat pad. I. Its role in the roentgenological visualization of abdominal organs. Radiology 1969; 92:466–472.PubMedGoogle Scholar
  66. 66.
    Arenas AP, Sanchez LV, Albillos JM et al: Direct dissemination of pathologic abnormal processes through perihepatic ligaments: Identification with CT. RadioGraphics 1994; 14:515–527.PubMedGoogle Scholar
  67. 67.
    McCort J: Anterior pararenal-space infection. Mt Sinai J Med 1984; 51:482–490.PubMedGoogle Scholar
  68. 68.
    Feldberg MAM, Hendriks MJ, van Waes P: Role of CT in diagnosis and management of complications of diverticular disease. Gastrointest Radiol 1985; 10:370–377.PubMedGoogle Scholar
  69. 69.
    Meyers MA, Oliphant M: Ascending retrocecal appendicitis. Radiology 1974; 110:295–299.PubMedGoogle Scholar
  70. 70.
    Feldberg MAM, Hendriks MJ, van Waes P: Computed tomography in complicated acute appendicitis. Gastrointest Radiol 1985; 10:289–295.PubMedGoogle Scholar
  71. 71.
    Ginzburg L, Oppenheimer GD: Urological complications of regional ileitis. J Urol 1948; 59:948–952.PubMedGoogle Scholar
  72. 72.
    Galen C: On the Usefulness of the Parts of the Body. Translated by May MT. Cornell University Press, Ithaca, 1968.Google Scholar
  73. 73.
    Roman E, Silva Y, Lucas C: Management of blunt duodenal injury. Surg Gynecol Obstet 1971; 132:7–14.PubMedGoogle Scholar
  74. 74.
    Glazer GM, Buy JN, Moss AA et al: CT detection of duodenal perforation. AJR 1981; 137:333–336.PubMedGoogle Scholar
  75. 75.
    Rizzo MJ, Federle MP, Griffiths BG: Bowel and mesenteric injury following blunt abdominal trauma: Evaluation with CT. Radiology 1989; 173:143–148.PubMedGoogle Scholar
  76. 76.
    Mirvis SE, Gens DR, Shanmuganathan K: Rupture of the bowel after blunt abdominal trauma: Diagnosis with CT. AJR 1992; 159:1217–1221.PubMedGoogle Scholar
  77. 77.
    Kunin JR, Korobkin M, Ellis JH et al: Duodenal injuries caused by blunt abdominal trauma: Value of CT in differentiating perforation from hematoma. AJR 1993; 160:1221–1223.PubMedGoogle Scholar
  78. 78.
    Sperling L, Rigler LG: Traumatic retroperitoneal rupture of duodenum: Description of valuable roentgen observations in its recognition. Radiology 1937; 29:521–524.Google Scholar
  79. 79.
    Toxopeus MD, Lucas CE, Krabbenhoft KL: Roentgenographic diagnosis in blunt retroperitoneal duodenal rupture. AJR 1972; 115:281–288.Google Scholar
  80. 80.
    Vellacott KD: Intramural haematoma of the duodenum. Br J Surg 1980; 67:36–38.PubMedGoogle Scholar
  81. 81.
    Zeppa M, Forrest JV: Aortoenteric fistula manifested as an intramural duodenal hematoma. AJR 1991; 157:47–48.PubMedGoogle Scholar
  82. 82.
    Dembner AG, Jaffe CC, Simeone J et al: A new computed tomographic sign of pancreatitis. AJR 1979; 133:477–479.PubMedGoogle Scholar
  83. 83.
    Mendez G Jr, Isikoff MB, Hill MC: CT of acute pancreatitis: Interim assessment. AJR 1980; 135:463–469.PubMedGoogle Scholar
  84. 84.
    Meyers MA, Evans JA: Effects of pancreatitis on the small bowel and colon: Spread along mesenteric planes. AJR 1973; 119:151–165.Google Scholar
  85. 85.
    Myerson PJ, Berg GR, Spencer RP et al: Gallium-67 spread to the anterior pararenal space in pancreatitis: Case report. J Nucl Med 1977; 18:893–895.PubMedGoogle Scholar
  86. 86.
    Siegelman SS, Copeland BE, Saba GP et al: CT of fluid collections associated with pancreatitis. AJR 1980; 134:1121–1132.PubMedGoogle Scholar
  87. 87.
    Griffin JF, Sekiya T, Isherwood I: Computed tomography of pararenal fluid collections in acute pancreatitis. Clin Radiol 1984; 35:181–184.PubMedGoogle Scholar
  88. 88.
    Susman N, Hammerman AM, Cohen E: The renal halo sign in pancreatitis. Radiology 1982; 142:323–327.PubMedGoogle Scholar
  89. 89.
    Hashimoto T, Gokan T, Munechika H et al: Pathway to the lumbar triangle from the posterior pararenal space: CT evaluation of the spread of disease (abstr). Radiology 1994; 193:398.Google Scholar
  90. 90.
    Meyers MA, Feldberg MAM, Oliphant M: Grey Turner’s sign and Cullen’s sign in acute pancreatitis. Gastrointest Radiol 1989; 14:31–37.PubMedGoogle Scholar
  91. 91.
    Geis WP, Hodakowski GT: Lumbar hernia. In Nyhus LM, Condon RE (eds) Hernia, 4th ed. JB Lippincott, Philadelphia, 1995, pp 412–423.Google Scholar
  92. 92.
    Grynfeltt J: Quelques mots sur la hernie lombaire. Montpellier Med 1866; 16:323.Google Scholar
  93. 93.
    Lesshaft P: Lumbalgegren in anatomisch-chirurgischer Himsicht. Anat Physiol Wissensch Med 1870; 264.Google Scholar
  94. 94.
    Petit JL: Traité des maladies chirurgicales, et des opérations qui leur convenient, Vol. 2. T.F. Didot, Paris, 1774, pp 256–258.Google Scholar
  95. 95.
    Lawdahl RB, Moss CN, Van Dyke JA: Inferior lumbar (Petit’s) hernia. AJR 1986; 147:744–745.PubMedGoogle Scholar
  96. 96.
    Baker ME, Weinerth JL, Andriani RT et al: Lumbar hernia: Diagnosis by CT. AJR 1987; 148:565–567.PubMedGoogle Scholar
  97. 97.
    Siffring PA, Forrest TS, Frick MP: Hernias of the inferior lumbar space: Diagnosis with US. Radiology 1989; 170:190.PubMedGoogle Scholar
  98. 98.
    Grey Turner G: Local discoloration of the abdominal wall as a sign of acute pancreatitis. Br J Surg 1919; 7:394–395.Google Scholar
  99. 99.
    Dickson AP, Imrie CW: The incidence and prognosis of body wall ecchymosis in acute pancreatitis. Surg Gynecol Obstet 1984; 159:343–347.PubMedGoogle Scholar
  100. 100.
    Ghiatas AA, Nguyen VD, Perusek M: Subcutaneous soft tissue densities: A computed tomography indicator of severe pancreatitis. Gastrointest Radiol 1990; 15:17–21.PubMedGoogle Scholar
  101. 101.
    Fallis LS: Cullen’s sign in acute pancreatitis. Ann Surg 1937; 106:54–57.PubMedGoogle Scholar
  102. 102.
    Cox HT: Discoloration of abdominal wall in acute pancreatitis. Br J Surg 1945; 33:182–184.Google Scholar
  103. 103.
    Markman B, Barton FE: Anatomy of the subcutaneous tissue of the trunk and lower extremity. Plast Reconstr 1987; 80:248–254.Google Scholar
  104. 104.
    Johnson D, Dixon AK, Abrahams PH: The abdominal subcutaneous tissue: Computed tomographic, magnetic resonance, and anatomical observations. Clinical Anatomy 1996; 9:19–24.PubMedGoogle Scholar
  105. 105.
    Reid BG, Kune GA: Accuracy in diagnosis of acute pancreatitis. Med J Aust 1978; 1:583–587.PubMedGoogle Scholar
  106. 106.
    Cullen TS: A new sign in ruptured extrauterine pregnancy. Am J Obstet 1918; 7:457.Google Scholar
  107. 107.
    Feldberg MAM, van Leeuwen MS: The properitoneal fat pad associated with the falciform ligament: Imaging of extent and clinical relevance. Surg Radiol Anat 1990; 12:193–202.PubMedGoogle Scholar
  108. 108.
    Oliphant M, Berne AS, Meyers MA: Direct spread of subperitoneal disease into solid organs: Radiologic diagnosis. Abdom Imaging 1995; 20:141–147.PubMedGoogle Scholar
  109. 109.
    Horton KM, Fishman EK: Paraumbilical vein in the cirrhotic patient: Imaging with 3D CT angiography. Abdom Imaging 1998; 23:404–408.PubMedGoogle Scholar
  110. 110.
    Auh YH, Lim JH, Jeong YK et al: Anatomy of the peritoneal cavity and reflections. In Gourtsoyiannis NC, Yamada R, Stevenson GW et al (eds) Abdominal and Gastrointestinal Imaging Medical Virtual Textbook (
  111. 111.
    Podlaha J: Zur Frage des subkutanen Emphysems bei perforierten gastroduodenalen Geschwueren. Zentralbl Chir 1926; 53:2793–2841.Google Scholar
  112. 112.
    Scappaticci F, Markowitz SK: Intrahepatic pseudocyst complicating acute pancreatitis: Imaging findings. AJR 1995; 165:873–874.PubMedGoogle Scholar
  113. 113.
    Williams DM, Cho KJ, Ensminger WD et al: Hepatic falciform artery: Anatomy, angiographic appearance and clinical significance. Radiology 1985; 156:339–340.PubMedGoogle Scholar
  114. 114.
    Kim DE, Yoon H-K, Ko GY et al: Hepatic falciform artery: Is prophylactic embolization needed before short-term hepatic arterial chemoinfusion? AJR 1999; 172:1597–1599.PubMedGoogle Scholar
  115. 115.
    Casolo F, Bianco R, Franceschelli N: Perirenal fluid collection complicating chronic pancreatitis: CT demonstration. Gastrointest Radiol 1987; 12:117–120.PubMedGoogle Scholar
  116. 116.
    Weill F, Brun P, Rohmer P et al: Migrations of fluid of pancreatic origin: Ultrasonic and CT study of 28 cases. Ultrasound Med Biol 1983; 9:485–496.PubMedGoogle Scholar
  117. 117.
    Morehouse HT, Thornhill BA, Alterman DD: Right ureteral obstruction associated with pancreatitis. Urol Radiol 1985; 7:150–152.PubMedGoogle Scholar
  118. 118.
    Fishman M, Talner LB: Pancreatitis causing focal caliectasis. AJR 1991; 156:1005–1006.PubMedGoogle Scholar
  119. 119.
    Baker MK, Kopecky KK, Wass JL: Perirenal pancreatic pseudocyst: Diagnostic management. AJR 1983; 140:729–732.PubMedGoogle Scholar
  120. 120.
    Chen H-C, Tsang Y-M, Wu C-H et al: Perirenal fat necrosis secondary to hemorrhagic pancreatitis, mimicking retroperitoneal liposarcoma: CT manifestation. Abdom Imaging 1996; 21:546–548.PubMedGoogle Scholar
  121. 121.
    Rauch RF, Korobkin M, Silverman PM et al: Subcapsular pancreatic pseudocyst of the kidney. J Comput Assist Tomogr 1983; 7:536–538.PubMedGoogle Scholar
  122. 122.
    Blandino A, Scribano E, Aloisi G et al: Subcapsular renal spread of a pancreatic pseudocyst. Abdom Imaging 1996; 21:73–74.PubMedGoogle Scholar
  123. 123.
    Ranson JHC, Pasternak BS: Statistical methods for qualifying the severity of clinical acute pancreatitis. J Surg Res 1977; 22:79–91.PubMedGoogle Scholar
  124. 124.
    Ranson JHC: Etiological and prognostic factors in human acute pancreatitis: A review. Am J Gastroenterol 1982; 77:633–638.PubMedGoogle Scholar
  125. 125.
    Kivisaari L, Somer K, Standertskjold-Nordenstam CG et al: A new method for diagnosis of acute hemorrhagic-necrotizing pancreatitis using contrast-enhanced CT. Gastrointest Radiol 1984; 9:27–30.PubMedGoogle Scholar
  126. 126.
    Schroeder T, Kivisaari L, Somer K et al: Significance of extrapancreatic findings in computed tomography (CT) of acute pancreatitis. Eur J Radiol 1985; 5:273–275.Google Scholar
  127. 127.
    Block S, Maier W, Bittner R et al: Identification of pancreas necrosis in severe acute pancreatitis: Imaging procedures versus clinical staging. Gut 1986; 27:1035–1042.PubMedGoogle Scholar
  128. 128.
    Balthazar EJ, Ranson JHC, Naidich DP et al: Acute pancreatitis: Prognostic value of CT. Radiology 1985; 156:767–772.PubMedGoogle Scholar
  129. 129.
    Balthazar EJ: CT diagnosis and staging of acute pancreatitis. Radiol Clin North Am 1989; 27:19–37.PubMedGoogle Scholar
  130. 130.
    Balthazar EJ, Robinson DL, Megibow AJ et al: Acute pancreatitis: Value of CT in establishing prognosis. Radiology 1990; 174:331–336.PubMedGoogle Scholar
  131. 131.
    Johnson CD, Stephens DH, Sarr MG: CT of acute pancreatitis: Correlation between lack of contrast enhancement and pancreatic necrosis. AJR 1991; 156:93–95.PubMedGoogle Scholar
  132. 132.
    Vibhakar SD, Bellow EM: The bare area of the spleen: A constant CT feature of the ascitic abdomen. AJR 1984; 142:953–955.PubMedGoogle Scholar
  133. 133.
    Sivit CJ, Frazier AA, Eichelberger MR: Prevalence and distribution of extraperitoneal hemorrhage associated with splenic injury in infants and children. AJR 1999; 172:1015–1017.PubMedGoogle Scholar
  134. 134.
    Balachandran S, Leonard MH Jr, Kumar D et al: Patterns of fluid accumulation in splenic trauma: Demonstration by computed tomography. Abdom Imaging 1994; 19:515–520.PubMedGoogle Scholar
  135. 135.
    Meyers MA: Roentgen significance of the phrenicocolic ligament. Radiology 1970; 95:539–545.PubMedGoogle Scholar
  136. 136.
    Beaulieu CF, Mindelzun RE, Dolph J et al: The infraconal compartment: A multidirectional pathway for spread of disease between the extraperitoneal abdomen and pelvis. J Comput Assist Tomgr 1997; 21:223–228.Google Scholar
  137. 137.
    Aikawa H, Tanone S, Okino Y et al: Pelvic extension of retroperitoneal fluid: Analysis in vivo. AJR 1998; 171:671–677.PubMedGoogle Scholar
  138. 138.
    Oliphant M, Berne AS, Meyers MA: The subperitoneal space of the abdomen and pelvis: Planes of continuity. AJR 1996; 167:1433–1439.PubMedGoogle Scholar
  139. 139.
    Mastromatteo JF, Mindell HJ, Mastromatteo MF et al: Communications of the pelvic extraperitoneal spaces and their relation to the abdominal extraperitoneal spaces: Helical CT cadaver study with pelvic extraperitoneal injections. Radiology 1997; 202:523–530.PubMedGoogle Scholar
  140. 140.
    Trerotola SO, Kuhlman JE, Fishman EK: Bleeding complications of femoral catheterization: CT evaluation. Radiology 1990; 174:37–40.PubMedGoogle Scholar
  141. 141.
    Trerotola SO, Kuhlman JE, Fishman EK: CT and anatomic study of postcatheterization hematomas. Radiographics 1991; 11:247–258.PubMedGoogle Scholar
  142. 142.
    Congdon ED, Blumberg R, Henry W: Fasciae of fusion and elements of the fused mesenteries in the human adult. Am J Anat 1942; 70:251–279.Google Scholar
  143. 143.
    Fredet P: Péritoine Morphogenése et Morphologie. Fascias d’accolement. Anomalies péritonéales resultant d’un vice ou d’un arret de developpement. In de Poirrier P, Charpy A (eds) Traite d’Anatomie Humaine. Masson, Paris, 1900, pp 863–1053.Google Scholar
  144. 144.
    Treitz W: Ueber einen neuen Muskel am Duodenum des Menschen, ueber elastische Sehnen, und einige andere anatomische Verhaeltnisse. Vierteljahrsch f d prakt Heilkunde, Prag 1853; 37:113–144.Google Scholar
  145. 145.
    Toldt C: Bau und Wachsthumveraenderungen der Gekroese des Menschlichen Darmkanales. Denkschr d math naturwissensch Kl d Kaiserl Akad d Wissensch, Wien 1879; 41:1–56.Google Scholar
  146. 146.
    Oliphant M, Berne AS, Meyers MA: Bidirectional spread of disease via the subperitoneal space: The lower abdomen and pelvis. Abdom Imaging 1993; 18:117–125.PubMedGoogle Scholar
  147. 147.
    Vermooten V: The mechanism of perinephric and perinephritic abscesses: A clinical and pathological study. J Urol 1933; 30:181–193.Google Scholar
  148. 148.
    Polkey HJ, Vynalek WJ: Spontaneous non-traumatic perirenal and renal hematomas: Experimental and clinical study. Arch Surg 1933; 26:196–218.Google Scholar
  149. 149.
    Bacon RD: Respiratory pyelography: A study of renal motion in health and disease. AJR 1940; 44:71.Google Scholar
  150. 150.
    Nesbit RM, Dick VS: Pulmonary complications of acute renal and perirenal suppuration. AJR 1940; 44:161–169.Google Scholar
  151. 151.
    Kawashima A, Sandler CM, Corriere JN Jr et al: Ureteropelvic junction injuries secondary to blunt abdominal trauma. Radiology 1997; 205:487–492.PubMedGoogle Scholar
  152. 152.
    Friedenberg RM, Moorehouse H, Gade M: Urinomas secondary to pyelosinus backflow. Urol Radiol 1983; 5:23–29.PubMedGoogle Scholar
  153. 153.
    Morgan CL Jr, Grossman H: Posterior urethral valves as a cause of neonatal uriniferous perirenal pseudocyst (urinoma). Pediatr Radiol 1978; 7:29–32.PubMedGoogle Scholar
  154. 154.
    Crabtree EG: Pararenal pseudohydronephrosis: With report of three cases. Trans Am Assoc Genitourinary Surg 1935; 28:9–40.Google Scholar
  155. 155.
    Razzaboni G: Richerche sperimentali sulla pseudoidronefrosi. Arch Ital Chir 1922; 6:365–372.Google Scholar
  156. 156.
    Hudson HG, Hundley RR:: Pararenal pseudocyst. J Urol 1967; 97:439–443.PubMedGoogle Scholar
  157. 157.
    Weintrab HD, Rall KL, Thompson IM et al: Pararenal pseudocysts: Report of three cases. AJR 1964; 92:286–290.Google Scholar
  158. 158.
    Sauls CL, Nesbit RM: Pararenal pseudocysts: A report of four cases. J Urol 1962; 87:288–296.PubMedGoogle Scholar
  159. 159.
    Johnson CM, Smith DR: Calcified perirenal pseudohydronephrosis: Hydronephrosis with communicating perirenal cyst with calcification. J Urol 1941; 45:152–164.Google Scholar
  160. 160.
    Pyrah LN, Smiddy FG: Pararenal pseudohydronephrosis: A report of two cases. Br J Urol 1953; 25:239–246.PubMedGoogle Scholar
  161. 161.
    Macpherson RI, Gordon L, Bradford BF: Neonatal urinomas: Imaging considerations. Pediatr Radiol 1984; 14:396–399.PubMedGoogle Scholar
  162. 162.
    Suzuki Y, Sugihara M, Kuribayashi S et al: Uriniferous perirenal pseudocyst detected by 99mTc-dimercaptosuccinic acid renal scan. AJR 1979; 133:306–308.PubMedGoogle Scholar
  163. 163.
    Healey ME, Teng SS, Moss AA: Uriniferous pseudocyst: Computed tomographic findings. Radiology 1984; 153:757–762.Google Scholar
  164. 164.
    Belville JS, Morgentaler A, Loughlin KR et al: Spontaneous perinephric and subcapsular renal hemorrhage: Evaluation with CT, US, and angiography. Radiology 1989; 172:733–738.PubMedGoogle Scholar
  165. 165.
    Mukamel E, Nissenkorn I, Avidor I et al: Spontaneous rupture of renal and ureteral tumors presenting as acute abdominal condition. J Urol 1979; 122:696–698.PubMedGoogle Scholar
  166. 166.
    Watnick M, Spindola-Franco H, Abrams HL: Small hypernephroma with subcapsular hematoma and renal infarction. J Urol 1972; 108:534–536.PubMedGoogle Scholar
  167. 167.
    Sherman JL, Hartman DS, Friedman AC et al: Angiomyolipoma: Computed tomography – pathologic correlation of 17 cases. AJR 1981; 137:1221–1226.PubMedGoogle Scholar
  168. 168.
    Bosniak MA: Spontaneous subcapsular and perirenal hematomas (editorial). Radiology 1989; 172:601–602.PubMedGoogle Scholar
  169. 169.
    Mastrodomenico L, Korobkin M, Silverman PM et al: Perinephric hemorrhage from metastatic carcinoma to the kidney. J Comput Assist Tomogr 1983; 7:727–729.PubMedGoogle Scholar
  170. 170.
    Ralls PW, Barakos JA, Kaptein EM et al: Renal biopsy-related hemorrhage: Frequency and comparison of CT and sonography. J Comput Assist Tomogr 1987; 11:1031–1034.PubMedGoogle Scholar
  171. 171.
    Castoldi MC, Del Moro RM, D’Urbano ML et al: Sonography after renal biopsy: Assessment of its role in 230 consecutive cases. Abdom Imaging 1994; 19:72–77.PubMedGoogle Scholar
  172. 172.
    Rubin JI, Arger PH, Pollack HM et al: Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. Radiology 1987; 162:21–24.PubMedGoogle Scholar
  173. 173.
    Rosen A, Korobkin M, Silverman PM et al: CT diagnosis of ruptured abdominal aortic aneurysm. AJR 1984; 143:265–268.PubMedGoogle Scholar
  174. 174.
    Siegel CL, Cohan RH: CT of abdominal aortic aneurysms. AJR 1994; 163:17–29.PubMedGoogle Scholar
  175. 175.
    Raptopoulos V, Cumming I, Smith EH: Computed tomography of life-threatening complications of abdominal aortic aneurysm: The disrupted aortic wall. Invest Radiol 1986; 22:372–376.Google Scholar
  176. 176.
    Siegel CL, Cohan RH, Korobkin M et al: Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR 1994; 163:1123–1129.PubMedGoogle Scholar
  177. 177.
    Mehard WB, Heiken JP, Sicard GA: High-attenuating crescent in abdominal aortic aneurysm wall at CT: A sign of acute or impending rupture. Radiology 1994; 192:359–362.PubMedGoogle Scholar
  178. 178.
    Middleton WD, Smith WD, Foley WD: CT detection of aortocaval fistula. J Comput Assist Tomogr 1987; 11:344–347.PubMedGoogle Scholar
  179. 179.
    Koslin DB, Kenney PJ, Stanley RJ et al: Aortocaval fistula: CT appearance with angiographic correlation. J Comput Tomogr 1987; 11:348–350.Google Scholar
  180. 180.
    Mackenzie AR: Spontaneous subcapsular renal hematoma: Report of case misdiagnosed as acute appendicitis. J Urol 1960; 84:243–245.PubMedGoogle Scholar
  181. 181.
    Engel WJ, Page IH: Hypertension due to renal compression resulting from subcapsular hematoma. J Urol 1955; 73:735–739.PubMedGoogle Scholar
  182. 182.
    Marshall WH Jr, Castellino RA: Hypertension produced by constricting capsular renal lesions (“Page” kidney). Radiology 1971; 101:561–565.PubMedGoogle Scholar
  183. 183.
    Takahashi M, Tamakawa Y, Shibata A et al: Computed tomography of “Page” kidney. J Comput Assist Tomogr 1977; 1:344–348.PubMedGoogle Scholar
  184. 184.
    Page IH: Production of persistent arterial hypertension by cellophane and perinephritis. JAMA 1939; 113:2046–2048.Google Scholar
  185. 185.
    Meyers MA, Friedenberg RM, King MC et al: The significance of the renal capsular arteries. Br J Radiol 1967; 40:949–956.PubMedGoogle Scholar
  186. 186.
    Koehler PR, Talner LB, Friedenberg MJ et al: Association of subcapsular hematomas with non-functioning kidney. Radiology 1973; 101:537–542.Google Scholar
  187. 187.
    Schaner EG, Barlow JE, Doppman JL: Computed tomography in the diagnosis of subcapsular and perirenal hematoma. AJR 1977; 129:83–88.PubMedGoogle Scholar
  188. 188.
    Zagoria RJ, Dyer RB, Assimos DG et al: Spontaneous perinephric hemorrhage: Imaging and management. J Urol 1991; 145:468–471.PubMedGoogle Scholar
  189. 189.
    Antonopoulos P, Drossos CH, Triantopoulou CH et al: Complications of renal angiomyolipomas: CT evaluation. Abdom Imaging 1996; 21:357–360.PubMedGoogle Scholar
  190. 190.
    Sacks D, Banner MP, Meranze SG et al: Renal and related retroperitoneal abscesses: Percutaneous drainage. Radiology 1988; 167:447–451.PubMedGoogle Scholar
  191. 191.
    Deyoe LA, Cronan JJ, Lambiase RE et al: Percutaneous drainage of renal and perirenal abscesses: Results in 30 patients. AJR 1990; 155:81–83.PubMedGoogle Scholar
  192. 192.
    Reznek RH, Mootoosamy I, Webb AW et al: CT in renal and perirenal lymphoma: A further look. Clin Radiol 1990; 42:233–238.PubMedGoogle Scholar
  193. 193.
    Villalon FC, Fernandez JE, Garcia TR: The hypoechoic halo: A finding in renal lymphoma. J Clin Ultrasound 1995; 23:379–381.Google Scholar
  194. 194.
    Bailey J, Roubidoux MA, Dunnick NR: Secondary renal neoplasms. Abdom Imaging 1998; 23:266–274.PubMedGoogle Scholar
  195. 195.
    Sheeran SR, Sussman SK: Renal lymphoma: Spectrum of CT findings and potential mimics. AJR 1998; 171:1067–1072.PubMedGoogle Scholar
  196. 196.
    Amis ES Jr: Retroperitoneal fibrosis. AJR 1991; 157:321–329.PubMedGoogle Scholar
  197. 197.
    Rominger MB, Kenney PJ: Perirenal involvement by retroperitoneal fibrosis: The usefulness of MRI to establish diagnosis. Urol Radiol 1992; 13:173–176.PubMedGoogle Scholar
  198. 198.
    Yancey JM, Kaude JV: Diagnosis of perirenal fibrosis by MR imaging. J Comput Assist Tomogr 1988; 12:335–337.PubMedGoogle Scholar
  199. 199.
    Rapezzi D, Racchi O, Ferraris AM et al: Perirenal extramedullary hematopoiesis in agnogenic myeloid metaplasia: MR imaging findings (letter to the editor). AJR 1997; 168:1388–1389.PubMedGoogle Scholar
  200. 200.
    Wright RE: Case report: Pararenal extramedullary haematopoietic tissue – an unusual manifestation of myelofibrosis. Clin Radiol 1991; 44:210–211.PubMedGoogle Scholar
  201. 201.
    Wilbur AC, Turk JN, Capek V: Perirenal metastases from lung cancer: CT diagnosis. J Comput Assist Tomogr 1992; 16:589–591.PubMedGoogle Scholar
  202. 202.
    Loughran CF: A review of the plain abdominal radiography in acute rupture of abdominal aortic aneurysms. Clin Radiol 1986; 37:383–387.PubMedGoogle Scholar
  203. 203.
    Nichols GB, Schilling PJ: Pseudoretroperitoneal gas in rupture of aneurysm of abdominal aorta. AJR 1975; 125:134–137.Google Scholar
  204. 204.
    Jeffrey RB Jr, Cardoza JD, Olcott EW: Detection of active intraabdominal arterial hemorrhage: Value of dynamic contrast-enhanced CT. AJR 1991; 156:725–729.PubMedGoogle Scholar
  205. 205.
    Hopper KD, Sherman JL, Ghaed N: Aortic rupture into retroperitoneum. Letter to the editor. AJR 1985; 145:435–437.PubMedGoogle Scholar
  206. 206.
    Kam J, Patel S, Ward RE: Computed tomography of aortic and aortoiliofemoral grafts. J Comput Assist Tomogr 1982; 6:298–303.PubMedGoogle Scholar
  207. 207.
    Mark A, Moss AA, Lusby R et al: CT evaluation of complications of abdominal aortic surgery. Radiology 1982; 145:409–414.PubMedGoogle Scholar
  208. 208.
    Low RN, Wall SD, Jeffrey RB Jr et al: Aortoenteric fistula and perigraft infection: Evaluation with CT. Radiology 1990; 175:157–162.PubMedGoogle Scholar
  209. 209.
    Calenoff L, Poticha SM: Combined occurrence of retropneumoperitoneum and pneumoperitoneum. AJR 1973; 17:366–372.Google Scholar
  210. 210.
    Meyers MA, Volberg F, Katzen B et al: Haustral anatomy and pathology: A new look. I. Roentgen identification of normal patterns and relationships. Radiology 1973; 108:497–504.PubMedGoogle Scholar
  211. 211.
    Meyers MA, Volberg F, Katzen B et al: Haustral anatomy and pathology: A new look. II. Roentgen interpretation of pathologic alterations. Radiology 1973; 108:505–512.PubMedGoogle Scholar
  212. 212.
    Kleinman PK, Brill PW, Whalen JP: Anterior pathway for transdiaphragmatic extension of pneumomediastinum. AJR 1978; 131:271–275.PubMedGoogle Scholar
  213. 213.
    Balthazar EJ, Moore SL: CT evaluation of infradiaphragmatic air in patients treated with mechanically assisted ventilation: A potential source of error. AJR 1996; 167:731–734.PubMedGoogle Scholar
  214. 214.
    McCourtney JS, Molloy RG, Anderson JR: Endoscopic esophageal perforation presenting as surgical emphysema of the scrotum (letter to the editor). Gastrointest Endosc 1994; 40:121–122.PubMedGoogle Scholar
  215. 215.
    Christensen EE, Landay MJ: Visible muscle of the diaphragm: Sign of extraperitoneal air. AJR 1980; 135:521–523.PubMedGoogle Scholar
  216. 216.
    Feldberg MAM, Koehler PR, van Waes P: Psoas compartment disease studied by computed tomography: Analysis of 50 cases and subject review. Radiology 1983; 148:505–512.PubMedGoogle Scholar
  217. 217.
    Van Dyke JA, Holley HC, Anderson SD: Review of the iliopsoas anatomy and pathology. RadioGraphics 1987; 7:53–85.PubMedGoogle Scholar
  218. 218.
    Torres GM, Cernigliaro JG, Abbitt PL et al: Iliopsoas compartment: Normal anatomy and pathologic processes. RadioGraphics 1985; 15:1285–1297.Google Scholar
  219. 219.
    Lenchik L, Dovgan DJ, Kier R: CT of the iliopsoas compartment: Value in differentiating tumor, abscess, and hematoma. AJR 1994; 162:83–86.PubMedGoogle Scholar
  220. 220.
    Han M-C, Kim C-W: Sectional Human Anatomy, 2nd ed. Ilchokak, Seoul, 1989.Google Scholar
  221. 221.
    Grégoire R, Oberlin S: Precis d’anatomie, 10th ed. J.B. Ballie`re, Paris, 1991.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Morton A. Meyers
    • 1
  • Chusilp Charnsangavej
    • 2
  • Michael Oliphant
    • 3
  1. 1.State University of New YorkStony BrookUSA
  2. 2.The University of Texas, M.D. Anderson Cancer CenterHoustonUSA
  3. 3.Department of RadiologyWake Forest University, School of MedicineWinston-SalemUSA

Personalised recommendations