Peritoneal recesses
Peritoneal Recesses
The peritoneal recesses are potential spaces within the peritoneal cavity that are formed by folds of the peritoneum. These recesses are clinically significant as they can be sites where fluid or infection may accumulate. Understanding the anatomy of these recesses is important for surgeons and clinicians in diagnosing and treating abdominal conditions.
Anatomy
The peritoneal cavity is lined by the peritoneum, a serous membrane that forms a closed sac. The peritoneum is divided into the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which covers the abdominal organs. The peritoneal recesses are formed by the folds and reflections of the peritoneum.
Subphrenic Recess
The subphrenic recess is located between the diaphragm and the liver. It is divided into right and left subphrenic spaces by the falciform ligament. This recess is clinically important as it can be a site for the accumulation of pus or fluid in cases of peritonitis.
Hepatorenal Recess
The hepatorenal recess, also known as Morison's pouch, is situated between the liver and the right kidney. It is the most dependent part of the peritoneal cavity when a person is lying supine, making it a common site for fluid accumulation in conditions such as ascites or hemoperitoneum.
Paracolic Gutters
The paracolic gutters are grooves between the lateral aspect of the colon and the abdominal wall. There are right and left paracolic gutters, which allow the passage of fluid and can facilitate the spread of infection or cancer within the peritoneal cavity.
Rectouterine and Rectovesical Pouches
In females, the rectouterine pouch (also known as the pouch of Douglas) is the space between the rectum and the uterus. In males, the rectovesical pouch is the space between the rectum and the bladder. These pouches are the lowest points of the peritoneal cavity in the upright position and can be sites for fluid collection.
Clinical Significance
The peritoneal recesses are important in the context of abdominal surgery and radiology. They can be sites of abscess formation, fluid collection, or spread of disease. Understanding their anatomy helps in the interpretation of imaging studies and in planning surgical interventions.
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Contributors: Prab R. Tumpati, MD