CAUSES OF INCREASING WIDTH OF RIGHT ANTERIOR EXTRARENAL SPACE SEEN INULTRASONOGRAPHIC EXAMINATIONS

The right anterior extrarenal space is composed of the perirenal fasci a, the right anterior perirenal space, the right anterior pararenal sp ace, and the liver capsule. To clarify the probable causes of an incre asing width of the right anterior extrarenal space, the width was meas ured using ultrasonography for a period of 8 months. The right anterio r extrarenal space was measured 3 cm from the superior renal pole and the smallest width obtained in several different scan planes was used. In 1,114 ultrasound examinations, 35 patients were found to have an i ncreased width of the right anterior extrarenal space. Among the 35 ca ses, the common probable causes for such a condition were found in 27 cases. Eight patients had hyperechogenicity in the right pararenal spa ce, a condition considered to be due to an acute inflammation, includi ng acute pancreatitis, acute cecal diverticulitis, acute appendicitis, ischemic bowel, acute cholangitis, liver abscess, and penetrated duod enal ulcer. Chronic inflammations of an adjacent organ, a previous his tory of laparotomy, a malignancy with peritoneal metastases, and treat ment with corticosteroid were considered the causes behind the conditi on in the 19 patients with normal echogenicity. For the remaining 8 pa tients, causes were not found during the follow-up period. This study indicates that life-threatening diseases, such as acute or chronic inf lammatory diseases and malignancy of the abdomen, could be the cause o f an increase in the width of this space. (C) 1995 John Wiley and Sons , Inc.