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Subperitoneal extension of disease processes between the chest, abdomen, and the pelvis

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Abstract

The subserous space is a large, anatomically continuous potential space that interconnects the chest, abdomen, and pelvis. The subserous space is formed from areolar and adipose tissue, and contains branches of the vascular, lymphatic, and nervous systems. As such, it provides one large continuous space in which many disease processes can spread between the chest, abdomen, and the pelvis.

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References

  1. Moore KL (2013) The developing human: clinically oriented embryology, Chap 8. In: Body cavities and diaphragm, 9th edn. Philadelphia: Saunders, pp 145–157

  2. Sadler TW (2012) Langman’s medical embryology, Chap 7. In: The gut tube and the body cavities, 12th edn. Baltimore: Wolters Kluwer Health, pp 86–95

  3. Oliphant M, Berne AS, Meyers MA (1999) The subserous thoracoabdominal continuum: embryologic basis and diagnostic imaging of disease spread. Abdom Imaging 24:211–219

    Article  CAS  PubMed  Google Scholar 

  4. Meyers MA (2011) Dynamic radiology of the abdomen, normal and pathologic anatomy, Chap 3. In: Clinical anatomy of the abdomen, 6th edn. New York: Springer, pp 23–40

  5. Brunicardi FC (2010) Schwartz’s principles of surgery, Chap 25. In: Esophagus and diaphragmatic hernia, 9th edn. New York: McGraw-Hill

  6. Skandalakis JE (2004) Skandalakis’ surgical anatomy, Chap 15. In: Stomach. New York: McGraw-Hill

    Google Scholar 

  7. Al-Motabagani MAH (2002) An anatomical study of the phrenoesophageal ligament. J Anat Soc India 51:18–22

    Google Scholar 

  8. Kleinman PK, Brill PW, Whalen JP (1978) Anterior pathway for transdiaphragmatic extension of pneumomediastinum. AJR 131:271–275

    Article  CAS  PubMed  Google Scholar 

  9. Balthazar EJ, Moore SL (1996) CT evaluation of infradiaphragmatic air in patients treated with mechanically assisted ventilation: a potential source of error. AJR 167:731–734

    Article  CAS  PubMed  Google Scholar 

  10. Heller MT, Haarer KA, Thomas E, Thaete F (2012) Acute conditions affecting the perinephric space: imaging anatomy, pathways of disease spread, and differential diagnosis. Emerg Radiol 19:245–254

    Article  PubMed  Google Scholar 

  11. Shleyfer E, Nevzorov R, Jotkowitz AB, et al. (2006) Urinothorax: an unexpected cause of pleural effusion. Eur J Intern Med 17:300–30210

    Article  PubMed  Google Scholar 

  12. Garcia-Pachon E, Padilla-Navas I (2004) Urinothorax: case report and review of the literature with emphasis on biochemical diagnosis. Respiration 71:533–536

    Article  PubMed  Google Scholar 

  13. Ray K, Rattan S, Yohannes T (2003) Urinothorax: unexpected cause of a pleural effusion. Mayo Clin Proc 78:1433–1434

    Article  PubMed  Google Scholar 

  14. Gore RM, Newmark GM, Thakrar KH, Mehta UK, Berlin JW (2009) Pathways of abdominal tumour spread: the role of the subperitoneal space. Cancer Imaging 9:112–120

    Article  PubMed Central  PubMed  Google Scholar 

  15. Oliphant M, Berne AS, Meyers MA (1996) The subperitoneal space of the abdomen and pelvis: planes of continuity. AJR 167:1433–1439

    Article  CAS  PubMed  Google Scholar 

  16. Pickhardt PJ, Bhalla S (2005) Unusual nonneoplastic peritoneal and subperitoneal conditions: CT findings. Radiographics 25:719–730

    Article  PubMed  Google Scholar 

  17. Molmenti EP, et al. (1996) Anatomy of the retroperitoneum: observations of the distribution of pathologic fluid collections. Radiology 200(1):95–103

    Article  CAS  PubMed  Google Scholar 

  18. Osman S, Lehnert BE, Elojeimy S, et al. (2013) A comprehensive review of the retroperitoneal anatomy, neoplasms, and pattern of disease spread. Curr Probl Diagn Radiol 42:191–208

    Article  PubMed  Google Scholar 

  19. Thornton FJ, Kandiah SS, Monkhouse WS, Lee MJ (2001) Helical CT evaluation of the perirenal space and its boundaries: a cadaveric study. Radiology 218:659–663

    Article  CAS  PubMed  Google Scholar 

  20. Aizenstein RI, Wilbur AC, O’Neal HK, et al. (1997) Interfascial and perinephric pathways in the spread of retroperitoneal disease: refined concepts based on CT observations. AJR 168:639–643

    Article  CAS  PubMed  Google Scholar 

  21. Lee SL, Ku YM, Rha SE (2010) Comprehensive reviews of the interfascial plane of the retroperitoneum: normal anatomy and pathologic entities. Emerg Radiol 17:3–11

    Article  PubMed  Google Scholar 

  22. Gore RM, Balfe DM, Aizenstein RI, Silverman PM (2000) The great escape: interfacial decompression planes of the retroperitoneum. AJR 175:363–370

    Article  CAS  PubMed  Google Scholar 

  23. Ishikawa K, et al. (2005) Traumatic retroperitoneal hematoma spreads through the interfascial planes. J Trauma 59(3):595–607 (discussion 607–8)

    PubMed  Google Scholar 

  24. Scialpi M, Scaglione M, Angelelli G, et al. (2004) Emergencies in the retroperitoneum: assessment of spread of disease by helical CT. Eur J Radiol 50:74–83

    Article  CAS  PubMed  Google Scholar 

  25. Auh YH, et al. (1986) Extraperitoneal paravesical spaces: CT delineation with US correlation. Radiology 159(2):319–328

    Article  CAS  PubMed  Google Scholar 

  26. Mastromatteo JF, Mindell HJ, Mastromatteo MF, et al. (1997) Communications of the pelvic extraperitoneal spaces and their relation to the abdominal extraperitoneal spaces: helical CT cadaver study with pelvic extraperitoneal injections. Radiology 202:523–530

    Article  CAS  PubMed  Google Scholar 

  27. Kim SW, Kim HC, Yang DM, Min GE (2013) The prevesical space: anatomical review and pathological conditions. Clin Radiol 68:733–740

    Article  CAS  PubMed  Google Scholar 

  28. O’Connell AM, Duddy L, Lee C, Lee MJ (2007) CT of pelvic extraperitoneal spaces: an anatomical study in cadavers. Clin Radiol 62:432–438

    Article  PubMed  Google Scholar 

  29. Bittle MM, Gunn ML, Gross JA, Stern EJ (2012) Trauma radiology companion: methods, guidelines, and imaging fundamentals. Philadelphia: Lippincott Williams & Wilkins, pp 234–239

    Google Scholar 

  30. Hashimoto M, Okane K, Hirano H, Watarai J (1998) Pictorial review: Subperitoneal spaces of the broad ligament and sigmoid mesocolon-imaging findings. Clin Radiol 53:875–881

    Article  CAS  PubMed  Google Scholar 

  31. Vikram R, Balachandran A, Bhosale PR, et al. (2009) Pancreas: peritoneal reflections, ligamentous connections, and pathways of disease spread. Radiographics 29:e34

    Article  PubMed  Google Scholar 

  32. Meyers MA (2011) Dynamic radiology of the abdomen, normal and pathologic anatomy, Chap 4. Mechanism of spread of disease in the abdomen and pelvis, 6th edn. New York: Springer, pp 41–68

  33. Kim SH, Shin SS, Jeong YY, et al. (2009) Gastrointestinal tract perforation: MDCT findings according to the perforation sites. Korean J Radiol 10:63–70

    Article  PubMed Central  PubMed  Google Scholar 

  34. Choi PW (2011) Pneumomediastinum caused by colonic diverticulitis perforation. J Korean Surg Soc 80(Suppl 1):S17–S20

    Article  PubMed Central  PubMed  Google Scholar 

  35. Murariu D, Tatsuno BK, Tom MK, You JS, Maldini G (2012) Subcutaneous emphysema, pneumopericardium, pneumomediastinum and pneumoretroperitoneum secondary to sigmoid perforation: a case report. Hawaii J Med Public Health 71:74–77

    PubMed Central  PubMed  Google Scholar 

  36. Alexiou K, Sakellaridis T, Sikalias N, et al. (2009) Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after unsuccessful ERCP: a case report. Cases J 2:120

    Article  PubMed Central  PubMed  Google Scholar 

  37. Marwan K, Farmer KC, Varley C, Chapple KS (2007) Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and subcutaneous emphysema following diagnostic colonoscopy. Ann R Coll Surg Engl 89:W20–W21

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Scichilone N, Buttacavoli M, Camarda G, et al. (2009) A 15-year-old boy with anterior chest pain, progressive dyspnea, and subcutaneous emphysema of the neck. J Allergy (Cairo) 2009:496890

    Google Scholar 

  39. Canivet JL, Yans T, Piret S, Frere P, Beguin Y (2003) Barotrauma-induced tension pneumoperitoneum. Acta Anaesthesiol Belg 54:233–236

    CAS  PubMed  Google Scholar 

  40. Koh ES, Chapeikin G (2004) Anterior infradiaphragmatic free gas following bronchial rupture: case report and literature review. Australas Radiol 48:58–60

    Article  PubMed  Google Scholar 

  41. Kim WH, Kim BH (2012) Bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after percutaneous tracheostomy: a case report. Korean J Anesthesiol 62:488–492

    Article  PubMed Central  PubMed  Google Scholar 

  42. Lostoridis E, Gkagkalidis K, Varsamis N, et al. (2013) Pneumoscrotum as complication of blunt thoracic trauma: a case report. Case Rep Surg 2013:392869

    PubMed Central  PubMed  Google Scholar 

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Disclosure of Commercial Interest

Dr. Moshiri is an author and consultant for Amyrsis. The remaining authors have no financial relationship with a commercial organization that may have a direct or indirect interest in the content.

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Authors and Affiliations

  1. Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 357115, Seattle, WA, 98195, USA

    Sherif Osman, Mariam Moshiri, Tracy J. Robinson, Martin Gunn, Bruce Lehnert & Dinesh Sundarkumar

  2. Department of Radiology, Winthrop University Hospital, 259 1st Street, Mineola, NY, 11501, USA

    Douglas S. Katz

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  1. Sherif Osman
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  2. Mariam Moshiri
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  3. Tracy J. Robinson
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  4. Martin Gunn
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  5. Bruce Lehnert
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  6. Dinesh Sundarkumar
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  7. Douglas S. Katz
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Correspondence to Mariam Moshiri.

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Osman, S., Moshiri, M., Robinson, T.J. et al. Subperitoneal extension of disease processes between the chest, abdomen, and the pelvis. Abdom Imaging 40, 1858–1870 (2015). https://doi.org/10.1007/s00261-014-0297-4

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