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Pathways of abdominal tumour spread: the role of the subperitoneal space.

Gore RM, Newmark GM, Thakrar KH, Mehta UK, Berlin JW - Cancer Imaging (2009)

Bottom Line: This space is formed by the subserosal areolar tissue that lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis.It contains the branches of the vascular, lymphatic, and nervous systems that supply the viscera.The subperitoneal space extends into the peritoneal cavity and is invested between the layers of the mesenteries and ligaments that support and interconnect the abdominal and pelvic organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, North Shore University Health System, University of Chicago, Evanston, IL 60201, USA. rgore@uchicago.edu

ABSTRACT
The subperitoneal space is a large, unifying, anatomically continuous potential space that connects the peritoneal cavity with the retroperitoneum. This space is formed by the subserosal areolar tissue that lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis. It contains the branches of the vascular, lymphatic, and nervous systems that supply the viscera. The subperitoneal space extends into the peritoneal cavity and is invested between the layers of the mesenteries and ligaments that support and interconnect the abdominal and pelvic organs. As such, it provides one large continuous space in which infectious, neoplastic, inflammatory, and hemorrhagic disease may spread in many directions.

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Transverse mesocolon: anatomic relationships and planes of disease spread. (A) Frontal diagram shows the relationships of the transverse mesocolon (TM). The transverse mesocolon is continuous with the root of the small bowel mesentery (SBM), the splenorenal ligament (SRL), and the phrenicocolic ligament (PCL). (From Okino Y, Kiyosue H, Mori H, et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics 2001; 21: 1480; with permission.) (B) Sagittal diagram through the transverse colon demonstrates preferential spread of pancreatic (P) disease through the transverse mesocolon, inferiorly along the taenia mesocolica–taenia libera (TL) haustra towards the TL–taenia omentalis (TO) row. This constitutes the inferior border of the transverse mesocolon. LS, lesser sac; S, stomach. (C) Fluid surrounds the middle colic vessels of the transverse mesocolon in this patient with pancreatitis. (From Meyers MA, Volberg R, Katzen B, et al. Haustral anatomy and pathology: a new look. II. Roentgen interpretation of pathologic alterations. Radiology 1973; 108: 505–12; with permission.)
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Figure 2: Transverse mesocolon: anatomic relationships and planes of disease spread. (A) Frontal diagram shows the relationships of the transverse mesocolon (TM). The transverse mesocolon is continuous with the root of the small bowel mesentery (SBM), the splenorenal ligament (SRL), and the phrenicocolic ligament (PCL). (From Okino Y, Kiyosue H, Mori H, et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics 2001; 21: 1480; with permission.) (B) Sagittal diagram through the transverse colon demonstrates preferential spread of pancreatic (P) disease through the transverse mesocolon, inferiorly along the taenia mesocolica–taenia libera (TL) haustra towards the TL–taenia omentalis (TO) row. This constitutes the inferior border of the transverse mesocolon. LS, lesser sac; S, stomach. (C) Fluid surrounds the middle colic vessels of the transverse mesocolon in this patient with pancreatitis. (From Meyers MA, Volberg R, Katzen B, et al. Haustral anatomy and pathology: a new look. II. Roentgen interpretation of pathologic alterations. Radiology 1973; 108: 505–12; with permission.)

Mentions: The transverse mesocolon is the linchpin that unites the various subperitoneal spaces and is a major conduit for both focal and distant spread of disease. On the right, the transverse mesocolon is continuous with the duodenocolic ligament; on the left, it is continuous with the phrenicocolic ligament; and centrally, it communicates with the small bowel mesentery[2–4,7] (Fig. 2).Figure 2


Pathways of abdominal tumour spread: the role of the subperitoneal space.

Gore RM, Newmark GM, Thakrar KH, Mehta UK, Berlin JW - Cancer Imaging (2009)

Transverse mesocolon: anatomic relationships and planes of disease spread. (A) Frontal diagram shows the relationships of the transverse mesocolon (TM). The transverse mesocolon is continuous with the root of the small bowel mesentery (SBM), the splenorenal ligament (SRL), and the phrenicocolic ligament (PCL). (From Okino Y, Kiyosue H, Mori H, et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics 2001; 21: 1480; with permission.) (B) Sagittal diagram through the transverse colon demonstrates preferential spread of pancreatic (P) disease through the transverse mesocolon, inferiorly along the taenia mesocolica–taenia libera (TL) haustra towards the TL–taenia omentalis (TO) row. This constitutes the inferior border of the transverse mesocolon. LS, lesser sac; S, stomach. (C) Fluid surrounds the middle colic vessels of the transverse mesocolon in this patient with pancreatitis. (From Meyers MA, Volberg R, Katzen B, et al. Haustral anatomy and pathology: a new look. II. Roentgen interpretation of pathologic alterations. Radiology 1973; 108: 505–12; with permission.)
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2821589&req=5

Figure 2: Transverse mesocolon: anatomic relationships and planes of disease spread. (A) Frontal diagram shows the relationships of the transverse mesocolon (TM). The transverse mesocolon is continuous with the root of the small bowel mesentery (SBM), the splenorenal ligament (SRL), and the phrenicocolic ligament (PCL). (From Okino Y, Kiyosue H, Mori H, et al. Root of the small-bowel mesentery: correlative anatomy and CT features of pathologic conditions. Radiographics 2001; 21: 1480; with permission.) (B) Sagittal diagram through the transverse colon demonstrates preferential spread of pancreatic (P) disease through the transverse mesocolon, inferiorly along the taenia mesocolica–taenia libera (TL) haustra towards the TL–taenia omentalis (TO) row. This constitutes the inferior border of the transverse mesocolon. LS, lesser sac; S, stomach. (C) Fluid surrounds the middle colic vessels of the transverse mesocolon in this patient with pancreatitis. (From Meyers MA, Volberg R, Katzen B, et al. Haustral anatomy and pathology: a new look. II. Roentgen interpretation of pathologic alterations. Radiology 1973; 108: 505–12; with permission.)
Mentions: The transverse mesocolon is the linchpin that unites the various subperitoneal spaces and is a major conduit for both focal and distant spread of disease. On the right, the transverse mesocolon is continuous with the duodenocolic ligament; on the left, it is continuous with the phrenicocolic ligament; and centrally, it communicates with the small bowel mesentery[2–4,7] (Fig. 2).Figure 2

Bottom Line: This space is formed by the subserosal areolar tissue that lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis.It contains the branches of the vascular, lymphatic, and nervous systems that supply the viscera.The subperitoneal space extends into the peritoneal cavity and is invested between the layers of the mesenteries and ligaments that support and interconnect the abdominal and pelvic organs.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, North Shore University Health System, University of Chicago, Evanston, IL 60201, USA. rgore@uchicago.edu

ABSTRACT
The subperitoneal space is a large, unifying, anatomically continuous potential space that connects the peritoneal cavity with the retroperitoneum. This space is formed by the subserosal areolar tissue that lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis. It contains the branches of the vascular, lymphatic, and nervous systems that supply the viscera. The subperitoneal space extends into the peritoneal cavity and is invested between the layers of the mesenteries and ligaments that support and interconnect the abdominal and pelvic organs. As such, it provides one large continuous space in which infectious, neoplastic, inflammatory, and hemorrhagic disease may spread in many directions.

Show MeSH
Related in: MedlinePlus