Presacral space

The presacral space is located between the rectum and the sacrococcygeal part of the spine.

The presacral space contains a variety of tissue:

  • fat
  • mesenchymal tissue
  • lymph nodes
  • nerve plexuses
  • blood vessels
  • superior - peritoneal reflections
  • inferior - levator ani and coccygeus muscles
  • laterally - ureter, iliac vessels 1

An increase in the width of the presacral space measurement is considered indicative of pathology in the rectum or other structures in the pelvis. This alteration is usually seen in lower GI barium enema studies and on plain film. 

The upper limits of normal for the presacral space width is 15mm in patients younger than 45 years 2. However, some patients have measurements over 15mm with no apparent reason (fewer still have measurements above 20 mm), which increases with older age. Factors such as sex and weight of the patient should also be taken into consideration 2.

Anatomy: Abdominopelvic
Share article

Article information

rID: 13174
Section: Anatomy
Synonyms or Alternate Spellings:
  • Pre-sacral space

Support Radiopaedia and see fewer ads

Cases and figures

  • Figure 1: anatomy of the presacral space
    Drag here to reorder.
  • Case 1: sagittal view of presacral space
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.