The abdomen has been conveniently divided anatomically and clinically into specific intraperitoneal and extraperitoneal sites. A recognition of the pathways of spread and localizing features of infections, malignancies, and traumatic collections has immeasurably extended diagnostic imaging capabilities. Yet, while the abdomen may be visualized as subdivided into compartments, it must also be essentially appreciated that these compartments are an actual or potential interconnecting network. In the upper abdomen peritoneal reflections comprise 11 major ligaments and mesenteries. These are generally readily recognizable on computed tomographic scans by either their typical location and organ relationships or the landmarks provided by their major constituent vessels. These ligaments and mesenteries provide continuity of anatomic planes, which permits the spread of disease between intraperitoneal compartments, between extraperitoneal spaces, and between intraperitoneal and extraperitoneal localized sites.

No abstract

The dorsal defect of the patella is described and 16 cases are presented. The typical dorsal patellar defect is a round, radiolucent lesion surrounded by a zone of sclerosis located on the superolateral aspect of the dorsal surface of the patella. The location, radiographic appearance and clinical course of the defect are unique, distinguishing it from other lesions of the patella. The authors suggest that the dorsal defect is an anomaly of Ossification and of little clinical significance.

This report establishes and details the clinical concept of the subperitoneal space and the subpleural space as components of the continuum formed by the subserous space. The subserous space is an anatomic plane formed in the embryo that persists during development into the adult. This is the basis of the thoracoabdominal continuum. The embryologic development is presented from the viewpoint not of the contents and their relationships within the developing coelomic cavity but rather that of a continuous space deep to the lining serous membrane. Clinical material is presented that illustrates different disease processes that can directly spread in either direction within this continuum. This unifying concept provides an understanding of the pathogenesis of direct spread of disease processes within and between the thorax and abdomen.