Retroperitoneal Space

spatium retroperitoneale

The retroperitoneal space, or retroperitoneum, is the region of the abdomen behind the parietal peritoneum and in front of the posterior abdominal wall muscles. It contains the kidneys, adrenals, ureters, aorta, inferior vena cava, much of the duodenum and pancreas and the ascending and descending colon. The renal fascia divides it into perirenal and anterior and posterior pararenal spaces.

Anatomical Data

Boundaries & Contents

Location	Posterior abdomen, from the diaphragm to the pelvic brim.
Boundaries	Parietal peritoneum anteriorly Psoas, quadratus lumborum and transversus abdominis fasciae posteriorly Diaphragm above Continuous with the extraperitoneal space of the pelvis below
Contents	Kidneys and ureters Adrenal glands Abdominal aorta and inferior vena cava Pancreas (most) Duodenum (second to fourth parts) Ascending and descending colon Lumbar lymph nodes and sympathetic trunks

Biomechanics

Function & Actions

Holds the posterior abdominal organs and great vessels outside the peritoneal cavity.

Clinical Relevance

Clinical Notes

Bleeding into the retroperitoneum, for example from a ruptured aortic aneurysm, pelvic fracture or anticoagulant therapy, can be large yet produce few abdominal signs, showing only as flank bruising or back pain. Retroperitoneal organs are reached through posterior or lateral approaches without entering the peritoneal cavity.

Pathology

Common Injuries & Conditions

Retroperitoneal Haemorrhage

Bleeding behind the peritoneum from trauma, aneurysm rupture or anticoagulation, which can be severe yet hidden, sometimes revealed by flank bruising (Grey Turner sign).

Retroperitoneal Fibrosis

Fibrous tissue forming around the aorta and ureters in the retroperitoneum, which can obstruct the ureters and cause kidney failure.

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