Abstract
The kidneys are placed retroperitoneally on the posterior abdominal wall, the right
lower than the left. At the renal hilum are found, from before back, the renal vein,
artery, pelvis of the ureter and a small posterior artery branch. There are also lymphatics
and sympathetic fibres (T12–L1), which account for referred renal pain to the lower
abdominal wall and external genitalia. The pelvis of the ureter divides into two or
three major calyces, which divide into minor calyces, each indented by a renal papilla,
onto which discharge the renal tubules. The three fascial layers are: the capsule,
which is easily stripped from the healthy kidney; the perinephric fat; and the investing
renal fascia, which adheres to the structures at the hilum and usually tamponades
a closed rupture of the kidney, which can thus be treated conservatively. The ureter
is 25 cm long, comprising the pelvis and an abdominal, pelvic and vesical portion;
the last acting as a sphincter. The ureter is crossed by the gonadal vessels and may
be injured here in gynaecological surgery. The ureter can be identified as it constantly
crosses the common iliac artery at its bifurcation and then lies on the anterior aspect
of the internal iliac artery.
Keywords
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Copyright
© 2012 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
