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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+R+Coll+Surg+Engl
2013 ; 95
(7
): 519-22
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Scarpa s fascia and clinical signs: the role of the membranous superficial fascia
in the eponymous clinical signs of retroperitoneal catastrophe
#MMPMID24112501
Ullah SM
; Grant RC
; Johnson M
; McAlister VC
Ann R Coll Surg Engl
2013[Oct]; 95
(7
): 519-22
PMID24112501
show ga
INTRODUCTION: The membranous superficial fascia (MSF) was described early in the
19th century, as was its role in the clinical sign of urethral disruption.
Clinical signs of haemorrhage or leakage of pancreatic and biliary fluid into the
retroperitoneum, which were described throughout the 20th century, all relied on
circumscribed discolouration of the skin of the torso. The objective of this
study was to relate the anatomy of the MSF to clinical signs of retroperitoneal
catastrophe. METHODS: The MSF was dissected in the torso of seven embalmed
cadavers to note its extent and its attachments. The attachments of the MSF were
mapped to the areas of skin discolouration that are described in the clinical
signs. RESULTS: The well known extent of the MSF in the inguinal region, its
continuation into the perineum and its attachment to the fascia lata of the thigh
were confirmed with our method of dissection. Dissection was continued
superiorly, demonstrating continuation of the MSF over the entire torso with
loose fibrous attachment of the MSF to the deep fascia. The MSF is firmly
adherent to the midline of the abdomen except for the umbilicus, to a horizontal
line below the clavicles and laterally in the abdomen to form pockets. The lines
of firm adhesion correspond with the borders of the discoloured areas described
in the clinical signs. CONCLUSIONS: Circumscription of discolouration seen in the
eponymous clinical signs of retroperitoneal catastrophe is explained by
confinement of coloured retroperitoneal fluid by the MSF and its deep
attachments.