Abstract
A good understanding of the anatomy of the kidney and ureter is imperative while dealing
with patients with abdominal trauma and those undergoing abdominopelvic surgery. The
kidneys are situated in the retroperitoneum and are enveloped by the renal fascia.
The renal fascia prevents the extravasation of blood during renal trauma. The lower
poles of the kidneys are more prone to trauma as they are inferior to the 12th rib.
However, due to the proximity of the kidneys to the lower ribs and pleura there is
a risk of pleural injury during percutaneous renal interventions. Relative paucity
of blood vessels in the postero-lateral convex border of the kidney (Brodel's bloodless
line) provides a relatively safe access to the pelvicalyceal system. The ureter has
an abdominal and pelvic course and has three physiological narrowings: the uretero-pelvic
junction, the point where the ureters cross the common iliac artery and the intra-vesical
part of the ureter. These are the commonest sites for impacted calculi. The intra-vesical
portion of the ureter is the narrowest portion of the ureter and this oblique intramural
course helps in the formation of a functional sphincter that prevents vesico-ureteric
reflux. The ureter is at risk of injury during colonic, vascular and gynaecological
surgery.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Anaesthesia & Intensive Care MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Article Info
Publication History
Published online: May 15, 2015
Royal College of Anaesthetists CPD matrix: 3A03; 3A05Identification
Copyright
© 2015 Published by Elsevier Inc.
