E2026. When Will My Reflections Show? A Pictorial Review of the Potential Spaces in the Abdomen
  1. Chantal Chahine; University of Pennsylvania Health System
  2. Debra Whorms; University of Pennsylvania Health System
The peritoneal cavity is divided by ligaments and mesenteries into distinct anatomical regions. Understanding the anatomy of these spaces can be difficult as non-diseased peritoneal folds and ligaments are difficult to visualize, obscuring the boundaries of these compartments. These spaces are however often involved in various abdominopelvic pathological processes, frequently acting as conduits for the spread of neoplastic and inflammatory processes. Knowledge of peritoneal anatomy can clue radiologists in to the path and pattern of spread of abdominopelvic pathology and further inform their differential diagnosis and increase their reporting accuracy. In this case-based review we will illustrate the detailed anatomy of the peritoneal spaces using cross sectional imaging of abdominopelvic pathology localizing to, and outlining, the different peritoneal ligaments, mesenteries and spaces.

Educational Goals / Teaching Points
Understand the anatomy of peritoneal ligaments and their attachments, describe the anatomy of the potential spaces of the abdominopelvic cavity, discuss the pathway of disease spread across contiguous peritoneal spaces, and appreciate the role of peritoneal ligaments as channels for the spread of disease.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The anatomic components discussed in this presentation will be the peritoneal ligaments, mesenteries, and spaces. Specifically this presentation will include the subphrenic spaces, the subhepatic spaces, the lesser sac, the infracolic spaces, the paracolic spaces, the transverse mesocolon, the sigmoid mesocolon, the small bowel mesentery, the ligaments of the liver, and the ligaments of the stomach. This anatomic review will be case-based and the structures will be depicted using magnetic resonance imaging and computed tomography with coronal and sagittal reformations. In order to better delineate the anatomy, cases with pathologic involvement of the structures of interest will be used; namely, cases of abdominopelvic metastases, spread of inflammation, and fluid collection.

A wide breadth of abdominopelvic pathology involves the peritoneal spaces. A lack of knowledge of these spaces may confound the radiologist's interpretation and differential diagnosis. A foundational understanding of peritoneal anatomy is essential to accurately recognize and report on abdominopelvic spread of disease.