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Perirenal fat is most abundant upon the posterior aspect, inferior pole and along the lateral margins of the kidney. [5] Anterior pararenal space. Bounded by the posterior layer of peritoneum and the anterior leaf of the renal fascia. It contains the following structures: Pancreas; Ascending and descending colon; Duodenum; Posterior pararenal space
The renal fascia separates the adipose capsule of kidney from the overlying pararenal fat. The deeper layers deep to the renal fascia are, in order, the adipose capsule (or perirenal fat), the renal capsule and finally the parenchyma of the renal cortex. [2] At the renal hilum, the renal capsule extends into the renal sinus. [1]
The kidney is surrounded by tough fibrous tissue, the renal capsule, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (rear) surface is the transversalis fascia. The superior pole of the right kidney is adjacent to the liver.
Overlying the renal fascia and between this and the transverse fascia is a region of pararenal fat. [1] The renal capsule resists stretching, limiting renal swelling, with important implications for renal circulation. [2] Stretching of the renal capsule due to swelling of the kidney causes flank pain. [3]
Bile, pus, or blood released from viscera anywhere along its length may run along the paracolic gutter, and collect in sites quite remote from the organ of origin. [2] In supine patients, infected fluid from the right iliac fossa may ascend in the paracolic gutter to enter the lesser sac.
Extraperitoneal fascia (also: endoabdominal fascia or subperitoneal fascia) is a fascial plane – consisting mostly of loose areolar connective tissue – situated between the fascial linings of the walls of the abdominal and pelvic cavities (transversalis fascia, anterior layer of thoracolumbar fascia, iliac fascia, and psoas fascia) externally, and the parietal peritoneum internally.
To the left side of the duodenojejunal flexure, recesses or fossae may be created by peritoneal folds. [2]The paraduodenal recess proper is situated posterior to the superior extremity of the inferior mesenteric vein.
The interstitium is the cells and extracellular matrix in the space between the glomeruli, vessels, tubules, and collecting ducts. [94] [95] The interstitial space surrounding cells is filled with interstitial fluid. [96] The interstitium between the tubules contains fibroblasts, dendritic cells, macrophages and lymphocytes.