zones of the retroperitoneum

Q: There are how many zones of the retroperitoneum?

Answer: Three

The retroperitoneum is divided into three zones which are used to describe the location of retroperitoneal hematomas. 

●Zone 1 is the central retroperitoneum, extending from the diaphragm superiorly to the bifurcation of the aorta inferiorly. The aorta, the inferior vena cava, the origins of the renal and major visceral vessels, a portion of the duodenum, and the pancreas lies in this zone. 

●Zone 2 includes both of the lateral perinephric areas of the upper retroperitoneum from the renal vessels medially to the lateral reflection of posterior parietal peritoneum of the abdomen, and extending from the diaphragm superiorly to the level of the aortic bifurcation inferiorly. Zone 2 contains the adrenal glands, the kidneys, the renal vessels, the ureters, and the ascending and descending colon. It is usually not contiguous. 

●Zone 3 is inferior to the aortic bifurcation and includes the right and left internal and external iliac arteries and veins, the distal ureter, the distal sigmoid colon, and the rectum.

#trauma


References:

1. Feliciano DV. Management of traumatic retroperitoneal hematoma. Ann Surg 1990; 211:109.


2. Bageacu S, Kaczmarek D, Porcheron J. Conduite à tenir devant un hématome rétro-péritonéal d'origine traumatique [Management of traumatic retroperitoneal hematoma]. J Chir (Paris). 2004;141(4):243-249. doi:10.1016/s0021-7697(04)95603-7