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ECR 2019 / C-2194
Retroperitoneal necroses: a challenge for the radiologist.
Congress: ECR 2019
Poster No.: C-2194
Type: Educational Exhibit
Keywords: Infection, Fistula, Acute, Surgery, CT-Angiography, CT, Conventional radiography, Retroperitoneum, Emergency, Abdomen
Authors: G. Columbano1, G. Corrias1, P. Siotto2, G. Micheletti1, G. T. Bitti2, L. Saba1; 1Monserrato/IT, 2Cagliari/IT


1.     ANATOMY


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).

-       Retromesenteric plane (RMS)

-       Retrorenal plane (RRP)

-       Lateroconal interfascial plane (LIP)

-       Combined interfascial plane (CIP) (Fig. 4).


1.2  Pelvic retroperitoneal space.

It is anatomically divided in the anterior and posterior compartments by the recto-prostatic fascia in the male and recto-vaginal fascia in the female (Fig. 5-Fig. 6).


1.3  Imaging

Identification of the retroperitoneal distribution of pathology can help the radiologist recognize the organs involved and thus suspect where the disease originated.

CT imaging plays an important role in emergency state because of its short acquisition time is suitable to obtain acceptable images in suffering. Furthermore, 3D MPR represents an important aid in both studying the abdomen and evaluating the extent of disease.


In Fig. 7-Fig. 8 are summarized the main CT findings in case of acute abdomen.

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