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The retroperitoneum
British Small Animal Veterinary Association , 40 (2009); https://doi.org/10.22233/9781905319718.5
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Abstract

The retroperitoneum is an extraperitoneal space situated ventral to the vertebrae and paraspinal muscles; it extends along the length of the entire abdomen from the diaphragm to the anus. The lateral boundaries are the abdominal and pelvic walls. The ventral boundary is the dorsal parietal peritoneum. Therefore, conditions affecting the peritoneum may spare the retroperitoneum. Organs that project freely into the abdominal, pelvic or scrotal cavities with an almost complete covering of peritoneum are considered to be intraperitoneal. However, those organs situated close to the walls of the abdominal or pelvic cavities and covered on one side only by peritoneum are considered to be retroperitoneal. Some of these organs are too small to be seen, whilst others are commonly seen on radiographs because they are surrounded by fat. Normal retroperitoneum; Ultrasonography; Overview of additional imaging modalities; and Retroperitoneal diseases are all addressed in this section.

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Figures

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5.1
Lateral abdominal radiograph showing the normal retroperitoneum of a 6-year-old male neutered Whippet. The presence of fat allows identification of some of the retroperitoneal structures, especially the left kidney. © 2009 British Small Animal Veterinary Association
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5.1 Lateral abdominal radiograph showing the normal retroperitoneum of a 6-year-old male neutered Whippet. The presence of fat allows identification of some of the retroperitoneal structures, especially the left kidney.
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5.2
Radiographs of an 11-year-old male neutered English Springer Spaniel that had suffered iatrogenic damage to the upper respiratory tract. Lateral radiograph of the cervical area. Air can be seen tracking along the fascial planes. Lateral thoracic radiograph. The clear boundaries of the mediastinal structures indicate the presence of pneumomediastinum. Close-up of a lateral radiograph of the thoracolumbar region. The aorta is clearly seen owing to the presence of air that is extending from the caudal mediastinum into the retroperitoneum. © 2009 British Small Animal Veterinary Association
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5.2 Radiographs of an 11-year-old male neutered English Springer Spaniel that had suffered iatrogenic damage to the upper respiratory tract. Lateral radiograph of the cervical area. Air can be seen tracking along the fascial planes. Lateral thoracic radiograph. The clear boundaries of the mediastinal structures indicate the presence of pneumomediastinum. Close-up of a lateral radiograph of the thoracolumbar region. The aorta is clearly seen owing to the presence of air that is extending from the caudal mediastinum into the retroperitoneum.
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5.3
Ultrasonogram of the normal retroperitoneum of a 13-year-old neutered Yorkshire Terrier bitch obtained in a longitudinal plane, parallel to the long axis of the body. Cranial is to the left. The aorta can be seen in the mid-field, surrounded by the normal retroperitoneum. Transverse image of the same area. Dorsal is to the left of the image. The shadowing caused by the descending colon is visible to the right of the image. © 2009 British Small Animal Veterinary Association
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5.3 Ultrasonogram of the normal retroperitoneum of a 13-year-old neutered Yorkshire Terrier bitch obtained in a longitudinal plane, parallel to the long axis of the body. Cranial is to the left. The aorta can be seen in the mid-field, surrounded by the normal retroperitoneum. Transverse image of the same area. Dorsal is to the left of the image. The shadowing caused by the descending colon is visible to the right of the image.
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5.4
Lateral abdominal radiograph of a 4-year-old neutered Jack Russell Terrier bitch following a recent road traffic accident. There is retroperitoneal enlargement and loss of detail due to fluid accumulation. Fractures of several vertebral transverse processes are evident and marked swelling of this area also contributes to the retroperitoneal enlargement. © 2009 British Small Animal Veterinary Association
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5.4 Lateral abdominal radiograph of a 4-year-old neutered Jack Russell Terrier bitch following a recent road traffic accident. There is retroperitoneal enlargement and loss of detail due to fluid accumulation. Fractures of several vertebral transverse processes are evident and marked swelling of this area also contributes to the retroperitoneal enlargement.
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5.5
Ultrasonogram of the retroperitoneum of a 5-year-old male neutered English Springer Spaniel presented with pyrexia and abdominal pain. A small anechoic pocket of fluid was detected caudal to the renal area. A migrating foreign body was suspected but was not found. © 2009 British Small Animal Veterinary Association
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5.5 Ultrasonogram of the retroperitoneum of a 5-year-old male neutered English Springer Spaniel presented with pyrexia and abdominal pain. A small anechoic pocket of fluid was detected caudal to the renal area. A migrating foreign body was suspected but was not found.
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5.6
Ultrasonogram of the cranial retroperitoneum of the dog shown in Figure 5.4 . There is fluid accumulation around the right kidney. Cranial is to the left. © 2009 British Small Animal Veterinary Association
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5.6 Ultrasonogram of the cranial retroperitoneum of the dog shown in Figure 5.4 . There is fluid accumulation around the right kidney. Cranial is to the left.
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5.7
Ultrasonograms of the central retroperitoneum of a 9-year-old male neutered Shih Tzu cross obtained with a 7 MHz curvilinear transducer and a 10 MHz linear transducer. Cranial is to the left. This pattern is consistent with fluid accumulation and carcinomatosis but is not specific for this condition. The final diagnosis was disseminated caudal retroperitoneal mast cell tumour. © 2009 British Small Animal Veterinary Association
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5.7 Ultrasonograms of the central retroperitoneum of a 9-year-old male neutered Shih Tzu cross obtained with a 7 MHz curvilinear transducer and a 10 MHz linear transducer. Cranial is to the left. This pattern is consistent with fluid accumulation and carcinomatosis but is not specific for this condition. The final diagnosis was disseminated caudal retroperitoneal mast cell tumour.
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5.8
Lateral and VD radiographs of the dog in Figure 5.4 after bladder catheterization, air insufflation and intravenous urography. The presence of positive contrast medium outside the bladder neck, extending cranially and surrounding intestinal loops in places confirms the suspicion of uroretroperitoneum and uroperitoneum. © 2009 British Small Animal Veterinary Association
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5.8 Lateral and VD radiographs of the dog in Figure 5.4 after bladder catheterization, air insufflation and intravenous urography. The presence of positive contrast medium outside the bladder neck, extending cranially and surrounding intestinal loops in places confirms the suspicion of uroretroperitoneum and uroperitoneum.
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5.9
Close-up of a lateral and a VD abdominal radiograph of a 4-year-old male neutered German Shepherd Dog with a 2-year history of intermittently discharging, fluctuating lesions of the left flank. The radiographs demonstrate the presence of gas (arrowed) accumulating deep within the flank lesion. A migrating foreign body was suspected. Surgery was declined. © 2009 British Small Animal Veterinary Association
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5.9 Close-up of a lateral and a VD abdominal radiograph of a 4-year-old male neutered German Shepherd Dog with a 2-year history of intermittently discharging, fluctuating lesions of the left flank. The radiographs demonstrate the presence of gas (arrowed) accumulating deep within the flank lesion. A migrating foreign body was suspected. Surgery was declined.
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5.10
Close-up of a lateral abdominal radiograph of a 2-year-old male English Cocker Spaniel showing a subtle periosteal reaction arising from the ventral aspect of the second lumbar vertebra. A retroperitoneal abscess was confirmed and surgically debrided following advanced imaging but no foreign body was found. © 2009 British Small Animal Veterinary Association
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5.10 Close-up of a lateral abdominal radiograph of a 2-year-old male English Cocker Spaniel showing a subtle periosteal reaction arising from the ventral aspect of the second lumbar vertebra. A retroperitoneal abscess was confirmed and surgically debrided following advanced imaging but no foreign body was found.
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5.11
Sagittal lumbar/abdominal and transverse T2-weighted MR images of a 2-year-old Labrador Retriever bitch presented for back pain of 6 weeks’ duration. The images show not only the presence of retroperitoneal changes compatible with abscessation (arrowed in a) but also the active involvement of the L3–L4 intervertebral disc space (arrowed in b) in the inflammatory process, extending from a large abscess within the paraspinal muscles (arrowheads). Part of a grass seed was retrieved at surgery. © 2009 British Small Animal Veterinary Association
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5.11 Sagittal lumbar/abdominal and transverse T2-weighted MR images of a 2-year-old Labrador Retriever bitch presented for back pain of 6 weeks’ duration. The images show not only the presence of retroperitoneal changes compatible with abscessation (arrowed in a) but also the active involvement of the L3–L4 intervertebral disc space (arrowed in b) in the inflammatory process, extending from a large abscess within the paraspinal muscles (arrowheads). Part of a grass seed was retrieved at surgery.
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5.12
STIR image in the dorsal plane at the level of the paravertebral muscles of the dog in Figure 5.5 . This image shows extensive hyperintense regions within the muscle, which were used to direct the surgeon during the cleaning and debriding procedure. STIR image in the dorsal plane at the level of the retroperitoneum of the dog in Figure 5.5 . This image shows extensive hyperintense regions within the muscle, which were used to direct the surgeon during the cleaning and debriding procedure. © 2009 British Small Animal Veterinary Association
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5.12 STIR image in the dorsal plane at the level of the paravertebral muscles of the dog in Figure 5.5 . This image shows extensive hyperintense regions within the muscle, which were used to direct the surgeon during the cleaning and debriding procedure. STIR image in the dorsal plane at the level of the retroperitoneum of the dog in Figure 5.5 . This image shows extensive hyperintense regions within the muscle, which were used to direct the surgeon during the cleaning and debriding procedure.
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5.13
Lateral abdominal radiograph of an 8-year-old male neutered Scottish Terrier. An irregularly shaped, dorsally located radiolucency indicates pneumoretroperitoneum. This arose when trying to perform a pneumocystogram for the investigation of chronic haematuria. The final diagnosis was transitional cell carcinoma of the prostate gland and bladder neck. © 2009 British Small Animal Veterinary Association
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5.13 Lateral abdominal radiograph of an 8-year-old male neutered Scottish Terrier. An irregularly shaped, dorsally located radiolucency indicates pneumoretroperitoneum. This arose when trying to perform a pneumocystogram for the investigation of chronic haematuria. The final diagnosis was transitional cell carcinoma of the prostate gland and bladder neck.
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5.14
Close-ups of lateral abdominal radiographs of a 9-year-old male neutered crossbreed dog with adenocarcinoma of the anal glands. An 8-month interval occurred between the first and the second radiograph. (a) Early enlargement of the medial iliac lymph nodes (short arrows) and periosteal reaction of the sixth lumbar vertebra (long arrow) are evident. (b) Dramatic progression is seen with massive enlargement of the lymph nodes (arrowed). © 2009 British Small Animal Veterinary Association
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5.14 Close-ups of lateral abdominal radiographs of a 9-year-old male neutered crossbreed dog with adenocarcinoma of the anal glands. An 8-month interval occurred between the first and the second radiograph. (a) Early enlargement of the medial iliac lymph nodes (short arrows) and periosteal reaction of the sixth lumbar vertebra (long arrow) are evident. (b) Dramatic progression is seen with massive enlargement of the lymph nodes (arrowed).

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