CT of pelvic extraperitoneal spaces: an anatomical study in cadavers

O'Connell, A.M.; Duddy, Lorna; Lee, C.; Lee, M.J.

doi:10.1016/j.crad.2006.11.012

Cited by 33 publications

(30 citation statements)

References 9 publications

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“…This finding is not consistent with the results of previous studies [29]. On the basis of our findings, an infection or tumor of the rectum would be confined within the perirectal space, so imaging findings showing preservation of the rectal fascia and localization of the disease process within the perirectal space would indicate that the disease process could not spread (if stopped using appropriate treatments) to the other extraperitoneal spaces.…”

Section: The Communication Of the Rectal Extraperitoneal Spacecontrasting

confidence: 99%

Radiologic and Anatomic Study of the Extraperitoneal Space Associated With the Rectum

Chen

Min

Liu

et al. 2010

American Journal of Roentgenology

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Section: The Communication Of the Rectal Extraperitoneal Spacecontrasting

confidence: 99%

Radiologic and Anatomic Study of the Extraperitoneal Space Associated With the Rectum

Chen

Min

Liu

et al. 2010

American Journal of Roentgenology

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“…In more severe acute pancreatitis, the pancreatic inflammatory process extends into the peripancreatic region [4,5,13,17], and other contiguous spaces, such as the anterior and posterior interfascial planes of the retroperitoneum, perirenal and posterior pararenal space, the root of the small bowel mesentery, as well as pelvic extraperitoneal space, may become involved because of direct or indirect communications between these different retroperitoneal compartments [9][10][11][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Gastric bare area and left adrenal gland involvement on abdominal computed tomography and their prognostic value in acute pancreatitis

et al. 2008

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To demonstrate the CT manifestations of gastric bare area involvement (GBAI) and left adrenal gland involvement (LAGI) in acute pancreatitis (AP) and evaluate their prognostic value. From January 2003 to December 2006, CT examinations of 116 patients with AP were retrospectively reviewed. There were 34 (29.3%) patients with GBAI showing haziness and streaky density or fluid collection in the gastric bare area, and 18 (15.5%) with LAGI showing deformity and hypoattenuation of left adrenal gland. The mean duration of hospital stay in patients with GBAI and LAGI was longer than that of patients without (P<0.001). The sensitivity and specificity of GBAI for predicting complications were 43.3% (0.31, 0.55) and 89.8% (0.81, 0.98), respectively; and 83.3% (0.36, 1.00) and 73.6% (0.65, 0.82) for predicting mortality. A patient with GBAI was 6.7 (2.4, 19.1) and 14.0 (1.6, 124.6) times more likely to have complications and die than was a patient without. The sensitivity and specificity of LAGI for predicting complications were 23.9% (0.14, 0.34) and 95.9% (0.86, 0.99), respectively, and 66.7% (0.22, 0.96) and 87.3% (0.81, 0.94) for predicting mortality. A patient with LAGI was 7.4 (1.6, 33.8) and 13.7 (2.3, 81.9) times more likely to have complications and die than was a patient without. Our results showed that GBAI and LAGI were characteristic CT findings in AP and could serve as useful prognostic indicators for this disease.

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“…Inferiorly, these communications are with the extraperitoneal pelvic spaces, and their associated organs such as the bladder, uterus, and rectum (31,32,38). The extraperitoneal pelvic spaces include the prevesicular space, perivesicular space, perirectal space, and presacral space.…”

Section: Pathways Of Spreadmentioning

confidence: 98%

Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

et al. 2015

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Retroperitoneal fasciitis is a rare but potentially lethal complication of infection. Early diagnosis is crucial and is usually made when there is a high degree of clinical suspicion combined with characteristic imaging findings leading to early surgical intervention. Computed tomography (CT) can play a central role in demonstrating early findings, assessing the extent of disease to help determine the best surgical approach, identifying the primary source of infection, and evaluating the treatment response. The possible presence of retroperitoneal fasciitis should be considered in patients presenting with symptoms of sepsis, including pain that is disproportionate with the clinical abnormality. When retroperitoneal fasciitis is suspected, emergency CT can facilitate early diagnosis and evaluation of the extent of disease. Common findings at CT include fascial thickening and enhancement, muscular edema, fat stranding, fluid collections, and abscess formation. Gas tracking along fascial planes in the retroperitoneum is the hallmark of retroperitoneal fasciitis but is not seen in all cases. Another important clue to the diagnosis is asymmetric involvement of the retroperitoneal fascial planes and deep tissues. Fasciitis in the retroperitoneum may originate from infected retroperitoneal organs or from infection that spreads along indirect and/or direct pathways from a primary source elsewhere in the body. Findings of indirect tracking and transgression of fascial planes may indicate more severe infection associated with the necrotizing form of retroperitoneal fasciitis. Despite aggressive antibiotic treatment, early and repeated surgical débridement may be required to remove nonviable tissue in patients with the necrotizing form of retroperitoneal fasciitis. Awareness of the anatomy of the retroperitoneum, potential routes of spread of infection, and the spectrum of CT findings in retroperitoneal fasciitis is needed to achieve prompt diagnosis and guide treatment.

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CT of pelvic extraperitoneal spaces: an anatomical study in cadavers

Cited by 33 publications

References 9 publications

Radiologic and Anatomic Study of the Extraperitoneal Space Associated With the Rectum

Radiologic and Anatomic Study of the Extraperitoneal Space Associated With the Rectum

Gastric bare area and left adrenal gland involvement on abdominal computed tomography and their prognostic value in acute pancreatitis

Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

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