Peritoneum & Retroperitoneal Flashcards
Kidneys lie in
Perirenal space
Striated hypo post to kidneys
Quadratus lumborum
Peri aorta several hypo meas > 2 cm adj to the celiac trunk and SMA. Most likely
Para aortic lymph nodes
Ab pain, inc serum amylase, fluid pocket in left pararenal space. Most likely
Pancreatic pseudocyst
Suspect retroperitoneal fibrosis. What structure image
Aorta
See lymph nodes adj to Abd aorta. Should include
Diameter meas of each lymph node
Patient has pheochromocytoma. Evaluate
Adrenals
Hx of lung cancer. MC mets from lung is ___ evaluate
Adrenals
Right adrenal gland location
Post to IVC
Looking for lymphadenopathy search
Splenic hilum, porta hepatis, renal hilum, and para aortic area
Striated posterior medial to kidney
Psoas muscle
Differentiating renal vs adrenal mass
Scan patient during deep inspiration and expiration. Adrenals are fixed. Kidneys will move.
Simulates adrenal mass
Thick diaphragmatic crus
Accessory spleen
Gastric Diverticulum
Retroperitoneal lymphadenopathy
Anatomic relationship of left adrenal gland
Lateral to the Abd aorta and diaphragmatic crus
Location of right diaphragmatic crus
Posterior to ivc and right renal artery
Criteria asses Nodular disease
Only lymph nodes meas > 1 cm are abnormal
Palp mass post renal tx anechoic mass with multiple septations lateral to midline
Lymphocele
Retroperitoneal compartment contain no solid organs
Posterior pararenal space and retrofascial space
Retroperitoneal compartment containing psoas and quadratus lumborum muscles
Retrofascial space
Retroperitoneal compartment mc involved with pseudocyst
Anterior pararenal space
Retroperitoneal compartment contains aorta
Anterior pararenal space
Greater sac
Diaphragm to pelvis
Lesser sac
Behind stomach
Peritoneum
Parietal layer: lines cavities
Visceral layer: lines organs
Mesentery
Attached sm intestine to abdominal wall
Greater and lesser omentum
Attaches stomach and duodenum
Spaces (where fluid can collect)
Rt & Lt subphrenic space Perihepatic Rt sub hepatic (morrisons pouch) Lt subhepatic (lesser sac and gastro hepatic recess) Perinephric space Paracolic gutters 4 Pelvic CDS (retrovesicle space)
Ligaments
Double folds of peritoneum
Falciform, coronary, lt triangular, Ligamentum teres, lig venosum, lesser omentum
Hernia
Defect in Abd wall, protrusion of contents, bowel peristalsis
Retroperitoneum
From diaphragm to pelvic floor
Contains: kidneys, adrenals, great vessels, pancreas, duodenal sweep, asc & desc colon, abd lymph nodes, somatic nerves, Prostate, uterus, bladder
Retroperitoneal spaces
Anterior pararenal space
Perirenal space
Posterior pararenal space
Lymphadenopathy
Floating aorta sign: nodes post to aorta elevate aorta and appears floating
Sandwich sign: nodes ant and post to aorta
Donut ring sign: all around aorta
Sonographic silhouette: nodes ant to aorta attenuate beam and can’t see ant wall of aorta
Retroperitoneal tumors
Primary tumors rare, usually mets
Can grow big before detected
Lymphoma, liposarcoma, leiomyosarcoma, teratoma, fibrosarcoma, myxosarcoma, Rhabdomyosarcoma
Benign tumors
Lipomas, sarcomas, fibromas, myxomas, teratomas, neurofibromas
Teratoma
Retroperitoneal 4th MC site
Retroperitoneal fibrosis
Fibrous tissue forms a hypo mass that blocks the ureters and causes hydronephrosis.
Hypo mass. Lower sacral region.
Assoc with aortic aneurysm
Cystic masses
Abscess, hematomas, urinomas, lymphocele
Fibrosarcoma US
Hyperechoic, complex
