Peritoneal surface area: measurements of 40 structures covered by peritoneum: correlation between total peritoneal surface area and the surface calculated by formulas

Surg Radiol Anat. 2009 Jun;31(5):369-77. doi: 10.1007/s00276-008-0456-9. Epub 2009 Jan 14.

Abstract

Background: We have not found studies that have measured the peritoneal surface area of each of the walls, organs, mesos, omenta, and peritoneal ligaments in a group of non-eviscerated human cadavers.

Objectives: The objectives of this study were to obtain in fixed non-eviscerated cadavers: (1) the surface values of walls, organs, mesos, omenta, and peritoneal ligaments of each one and all the areas mentioned in the anatomy bibliography and their contribution to supra- and infra-colic portions, visceral and parietal portions of the supra- and infra-colic portions and the total peritoneal surface area, and (2) the relationship between the peritoneal surface values by direct measurement and the values obtained applying the formulas usually used in clinical practice to obtain body surface area.

Methods: The peritoneal surface area of ten female human bodies presenting no abdominal pathologies were measured. They were fixed in 5% formaldehyde solution without the use of perfusion pumps and non-eviscerated, thus maintaining all structures intact. Cellophane was placed directly in situ onto all organs, mesos, omenta, ligaments and parietal walls. Digital imaging was obtained by scanning the models. A length reference was included and the surface was determined by the Scion Image program for Windows.

Results: This paper provides for the first time data on each one and all the areas covered by the peritoneum. The total peritoneal surface area was (mean +/- SE) 14,323.62 +/- 824.37 cm(2). The two greater surfaces of peritoneum (39.21% of the total surface) correspond to the jejunum-ileum and its mesentery. The diaphragmatic peritoneum represented the greater area of parietal peritoneum. The supracolic surface was 4,487.46 +/- 196.21 cm(2) (31.79 +/- 1.50%) and the infracolic one of 9,836.16 +/- 732.67 cm(2) (68.21 +/- 1.50%). An interesting result of this work is that the surface of the parietal peritoneum in the supracolic abdomen (1,786.67 +/- 92.58 cm(2), 68.56%) is more than twice that of the infracolic region (756.62 +/- 55.91 cm(2), 31.44%). The visceral peritoneal surface (81.89 +/- 0.99% of the total) was much higher than that of the parietal peritoneum (18.11 +/- 0.99%). This difference is 12 times bigger in the infracolic abdomen. The peritoneal surface area measured in this study in non-eviscerated cadavers represents more than 96% of the one estimated by the above-mentioned formulas.

Conclusion: The values shown in this paper would provide non-existing information for basic anatomy, and would contribute either to the study of pathologies involving the peritoneum or to their diagnosis and therapies.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Body Surface Area
  • Female
  • Humans
  • Middle Aged
  • Peritoneum / anatomy & histology*
  • Viscera / anatomy & histology*