Retroperitoneal

Question 1

What organs does the retroperitoneal contain?

Answer 1

Supradrenal Glands
Aorta/IVC
Duodenum (2nd, 3rd, fourth parts)

Pancreas
Ureters
Colon (ascending/descending)
Kidneys
Esophagus
Rectum

Question 2

What are the 3 major compartments of the Retroperitoneum?

Answer 2

Anterior Pararenal Space
Perirenal/Perinephric Space
Posterior Pararenal Space

Question 3

Gerota’s fascia is the _______ renal fascia.

Answer 3

anterior

Question 4

Zuckerkland is the _______ renal fascia.

Answer 4

posterior

Question 5

The anterior pararenal space contains…

Answer 5

Fat, pancreas, distal CBD, second third fourth parts duodenum, ascending/descending colon

Question 6

The perirenal/perinephric space contains…

Answer 6

Kidneys, adrenal glands, perinephric fat, prevertebral AO and IVC

Question 7

The posterior pararenal space contains…

Answer 7

Fat. No organs!

Question 8

The left crus is to the _____ of the AO and inserts into the _____ tendon of the _______.

Answer 8

left, central, diaphragm

Question 9

Which is longer and more lobular - right or left crus?

Answer 9

Right

Question 10

What is a ‘collecting area in the mid-retroperitoneum that collects lymph from lower extremities and pelvis before ascending to the thoracic duct’?

Answer 10

Chyle Cistern

Question 11

What are the retroperitoneal fluid collections?

Answer 11

Abscesses, hematomas, urinomas, lymphoceles

Question 12

What is the most common site of retroperitoneal infections?

Answer 12

Anterior pararenal space (APS)

Question 13

What space is usually associated with renal abnormalities?

Answer 13

Perirenal Space (Gerota fascia)

Question 14

What kind of hematomas can occur to the kidneys?

Answer 14

Subscapular or in the renal tissue

Question 15

What is most commonly iatrogenic following node dissection?

Answer 15

Lymphocele

Question 16

How long does it take for a lymphocele to begin after surgery?

Answer 16

10-21 days, up to 8wks post renal transplant

Question 17

If large, what complications can lymphoceles create?

Answer 17

Hydronephrosis and edema

Question 18

What is a urinoma?

Answer 18

Extravasated urine into retroperitoneum due to a tear in the urinary collecting system.

Question 19

Where does urinoma typically form?

Answer 19

Perirenal space

Question 20

What has an etiology of: extension from adjacent organ (renal infection, diverticululitis, Crohn disease), or existing retroperi fluid collection that has become infected?

Answer 20

Abscess

Question 21

Abscesses can occur from…

Answer 21

Renal infection, diverticulitis, Crohn disease

Question 22

Retroperitoneal Fibrosis is also known as _______ disease or chronic ________.

Answer 22

Ormond, chronic periaortitis

Question 23

What does retroperitoneal Fibrosis usually affect/encase?

Answer 23

Great vessels, ureters, and retroperi lymphatics

Question 24

Retroperitoneal Fibrosis is most common in men or women?

Answer 24

Middle aged males

Question 25

What is the sonographic feature of Retroperitoneal Fibrosis?

Answer 25

HYPOechoic smoothly marginated clump/layer. Usually occurs in the para-aortic area of the perinephric space or around the ureters. Can cause medial deviation or stenosis leading to hydro if the ureters are affected.

Question 26

What is it called when the lymph nodes are enlarged due to inflammation, primary neoplasia, or mets?

Answer 26

Lymphadenopathy

Question 27

_______ is a common finding in patients with AIDS.

Answer 27

Lymphadenopathy

Question 28

What does lymphadenitis look like?

Answer 28

Enlarged lymph nodes that maintain shape and fatty hilum and demonstrate hyperemia.

Question 29

What does a malignant lymph node look like?

Answer 29

More round, lack of fatty hilum, hypoechoic to anechoic, asymmetrical cortical widening, potential avascular areas, mass effect on normal vascular tree

Question 30

Can nodes form together and form a mass around in the great vessels in lymphadenopathy?

Answer 30

Yes

Question 31

What is the most common malignant primary retropertioneal tumour?

Answer 31

Liposarcoma

Question 32

Malignant tumours cause mass effect on: (4 items)

Answer 32

IVC Ureters Bladder Extrahepatic Bile Duct

Question 33

What is the population most common for Liposarcomas?

Answer 33

Middle aged men

Question 34

What has a sonographic finding of: poorly marginated lobulated and complex mass, causes mass effect, typically very large in size (big mass), typically anterior to spine and psoas muscles?

Answer 34

Liposarcoma

Question 35

What malignant primary neoplasm of the retroperitoneal is most common in women?

Answer 35

Leiomyosarcoma

Question 36

What is the sonographic appearance of a leiomyosarcoma?

Answer 36

Complex lesion with internal necrosis and hemorrhage, well-circumscribed, erosion of adjacent visceral wall may result in gas/air within the mass