Properitoneal fat
Citation, DOI, disclosures and article data
At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosuresAt the time the article was last revised Joshua Yap had no financial relationships to ineligible companies to disclose.
View Joshua Yap's current disclosures- Properitoneal fat pad
- Properitoneal fat plane
- Properitoneal fat line
- Properitoneal fat stripe
- Pro-peritoneal fat
- Flank stripe
- Preperitoneal space
- Preperitoneal fat
The properitoneal fat, also known as the preperitoneal space, is a fat-containing space in the abdomen.
Posteriorly it lies deep to the transversalis fascia and fills the posterior pararenal space. Laterally it thickens and forms the properitoneal fat pad, which is the anterior extension of posterior pararenal space. It communicates superiorly with the falciform ligament and intersegmental fissure of the liver. Supero-medially it can communicate with extrapleural fat (via spaces of Larrey) 4. Inferiorly it is continuous with the pelvic extension of the posterior pararenal space which terminates as a potential space between the perivesical peritoneal folds 5.
Spread of hemorrhage or infection throughout this space can result in the clinical appearances of Cullen's sign and Grey Turner's sign 6.
On this page:
Terminology
The properitoneal fat pad is known as a plane in surgical anatomy, and as a line or stripe when seen on imaging. It is also referred to frequently as the flank stripe.
Contents
- fat
- ensiform veins
Radiographic features
Plain radiograph
- outlines the ascending and descending colon 3
Related pathology
Loss of the properitoneal fat line is associated with:
- appendicitis
- ruptured abdominal aortic aneurysm
- epigastric hernia
- pancreatitis (Cullen's sign, Grey Turner's sign)
- laparoscopic insufflation
A potential pitfall is that the properitoneal fat line can mimic pneumoperitoneum or pneumoretroperitoneum.
References
- 1. Thornton FJ, Kandiah SS, Monkhouse WS et-al. Helical CT evaluation of the perirenal space and its boundaries: a cadaveric study. Radiology. 2001;218 (3): 659-63. Pubmed citation
- 2. Hinman's Atlas of UroSurgical Anatomy: Expert Consult Online and Print, 2e. Saunders. ISBN:1416040897. Read it at Google Books - Find it at Amazon
- 3. ABC of emergency radiology. BMJ Books. ISBN:0727915282. Read it at Google Books - Find it at Amazon
- 4. Feldberg MA, Van Leeuwen MS. The properitoneal fat pad associated with the falciform ligament. Surgical and Radiologic Anatomy. 1990 Sep;12(3):193-202. Pubmed
- 5. Coffin A, Boulay-Coletta I, Sebbag-Sfez D, Zins M. Radioanatomy of the retroperitoneal space. Diagnostic and interventional imaging. 2015 Feb 1;96(2):171-86. Pubmed
- 6. Meyers MA, Feldberg MA, Oliphant M. Grey Turner's sign and Cullen's sign in acute pancreatitis. Gastrointestinal radiology. 1989 Dec;14(1):31-7.Pubmed
- 7. Vilaça AF, Reis AM, Vidal IM. The anatomical compartments and their connections as demonstrated by ectopic air. Insights into imaging. 2013 Dec 1;4(6):759-72. Pubmed
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