| Peritoneal recesses | |
|---|---|
 Diagram devised by Delépine to show the lines along which the peritoneum leaves the wall of the abdomen to invest the viscera. | |
| Anatomical terminology |
Peritoneal recesses (orperitoneal gutters) are the spaces formed byperitoneum draping overviscera.[1]
The term refers mainly to four spaces in the abdominal cavity; the twoparacolic gutters and the twoparamesenteric gutters. There are other smaller recesses including those around the duodenojejunal flexure, cecum, and the sigmoid colon. These gutters are clinically important because they allow a passage for infectious fluids from different compartments of the abdomen. For example; fluid from an infectedappendix can track up the right paracolic gutter to thehepatorenal recess.
The four peritoneal recesses are:
To the left side of theduodenojejunal flexure, recesses or fossae may be created by peritoneal folds.[2]
The paraduodenal recess proper is situated posterior to the superior extremity of theinferior mesenteric vein. This paraduodenal recess is clinically and surgically important: an internal hernia protruding into the recess may obstruct the inferior mesenteric vein or cause athrombus to form within it, and the vein may be sectioned during surgical repair of such a hernia.[2]
A superior and an inferior duodenal recess may be created by horizontal peritoneal folds.[2]
A retroduodenal recess may occur posterior to the duodenojejunal flexure.[2]
The small intestine mayherniate (a condition known as an "internal hernia") into these recesses, and such hernias may thenstrangulate.[3]
