1\ Retroperitoneal Space

The retroperitoneal space is a large potential space between the parietal peritoneum and the posterior abdominal wall muscles. It extends from the diaphragm to the pelvis. Its lateral boundaries are the equation of perpendicular line from the twelfth coastal space to the iliac crest. The parietal peritoneum, right liver bare area, duodenum, ascending colon, and port of the rectum lie anterior to it. The abdominal posterior wall, psoas major, and waist muscle are posterior to it. There are the aorta, inferior vena cava and their branches, pancreas, duodenum, adrenal gland, kidneys and ureters, sympathetic nerve,

cord, lymph node, lymph vessels, nerve trunk, ganglion, and spinal nerves in it. Bleeding and infection of the retroperitoneal space easily spread because of a lower resistance of the abdominal cavity. Being a potential space, the retroperitoneal space relied on adjacent organs and vassels to help in the localization. The scanning is carried out from top to bottom, from right to left.

1.1\ Transverse Scanning

on Superior Edge

of the Pancreas at Upper

Abdomen

Fig. 11.1  Transverse view on the superior edge of the pancreas by the upper abdomen

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1.1.1\ Scanning Method

The patient should be 8–12 hours on an empty stomach, with supine position. Probe is put on the subxiphoid. After showing the transverse view of the pancreas, probe will scan toward posterosuperior so as longitudinal section of the common hepatic artery and splenic artery can be got.

1.1.2\ Section Structure

Showing retroperitoneal structures. Longitudinal oblique section of the common hepatic artery,

proper hepatic artery, splenic artery, and celiac artery. The transverse section of the upper edge of the pancreas. Cross section of the inferior vena cava abdominal aorta.

1.1.3\ Clinical Application Value

The celiac artery and hepatic artery are located in the upper retroperitoneal space. Enlargement of the lymph nodes around the celiac artery and hepatic artery in the upper retroperitoneal cavity can be displayed.

1.2\ Transverse Scanning

of the Retroperitoneal Space Through the Pancreas by the Upper Abdomen

Fig. 11.2  Transverse scan of the retroperitoneal space by the upper abdomen

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1.2.1\ Scanning Method

Subject should be on fast for 8–12 hours with a supine position. Subxiphoid transverse scanning is ­performed. Patient can be in full inspiration to make the left liver lobe down as an acoustic window.

1.2.2\ Section Structure

Retroperitoneal structures are shown, including transverse section of the pancreas, long axial section of the spleen vein, and transverse section of the abdominal aorta, superior mesenteric artery,

superior mesenteric vein, inferior vena cava, and left kidney.

1.2.3\ Clinical Application Value

The abnormal structures around the pancreas, abdominal aorta, superior mesenteric artery, superior mesenteric vein, inferior vena cava , and left kidney such as the space-­occupying lesions, fluid collection, and lymph node enlargement should be considered to be the diseases in the retroperitoneal space.

1.3\ Transverse Scanning

of the Left Upper

Retroperitoneum

Fig. 11.3  Transverse section of left upper

retroperitoneum

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IVC

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1.3.1\ Scanning Method

Patient should be on fast for 8–12 h with supine position. Probe is put on the left upper abdomen and scans transversely.

1.3.2\ Section Structure

Long axial section of the pancreatic tail and transverse section of the abdominal aorta, supe-

rior mesenteric artery, superior mesenteric vein, inferior vena cava, left kidney, and left psoas major are shown in this plane.

1.3.3\ Clinical Application Value

Those structures are all located in the retroperitoneal space. The abnormal echogenicity around them belongs to retroperitoneal diseases.