Mesorectal fascia

Last revised by Vikas Shah ◉ on 21 Oct 2021

Citation, DOI, disclosures and article data

Citation:

Robertson S, Shah V, Deng F, et al. Mesorectal fascia. Reference article, Radiopaedia.org (Accessed on 22 Sep 2023) https://doi.org/10.53347/rID-57429

DOI:

https://doi.org/10.53347/rID-57429

Permalink:

https://radiopaedia.org/articles/57429

rID:

57429

Article created:

24 Dec 2017, Sarah Robertson

Disclosures:

At the time the article was created Sarah Robertson had no recorded disclosures.

View Sarah Robertson's current disclosures

Last revised:

21 Oct 2021, Vikas Shah ◉

Disclosures:

At the time the article was last revised Vikas Shah had no recorded disclosures.

View Vikas Shah's current disclosures

Revisions:

6 times, by 4 contributors - see full revision history and disclosures

Systems:

Gastrointestinal

Sections:

Anatomy

The mesorectal fascia is a layer of connective tissue enclosing the perirectal fat that surrounds the rectum. It is an important anatomical structure in rectal cancer staging, as it forms the circumferential resection margin for the non-peritonealised portion of the rectum.

location: envelopes the perirectal fat which surrounds the rectum within the pelvis
boundaries: extends from the beginning of the rectum to levator ani
contents: perirectal fat which contains the superior rectal artery and branches, superior rectal vein and tributaries, and lymph nodes and vessels

Gross anatomy

The mesorectal fascia begins at the rectosigmoid junction where it blends with the connective tissue of the sigmoid mesentery. It extends to the end of the rectum at levator ani. Laterally it extends around the rectum and perirectal fat and becomes contiguous anteriorly with the rectovesical fascia (Denonvilliers fascia). Posteriorly it fuses with the presacral fascia (Waldeyer fascia). Note that a variable circumference of the rectum is enveloped by the mesorectal fascia, owing to the fact that the peritoneum reflects off the anterior aspect of the middle and upper thirds of the rectum (see Figure 1).

encloses the perirectal fat which in turn contains:
- superior rectal artery and branches
- superior rectal vein and tributaries
- lymph nodes and vessels

Relations

posterior: presacral fascia, S3-S5, coccyx, median sacral nerves, sacral sympathetic chain
anterior:
- male: bladder, ureter, prostate, seminal vesicle
- female: bladder, ureter, vagina, rectovaginal septum
inferior: piriformis muscle
lateral: sigmoid colon, terminal ileum