Right subphrenic space
The right subphrenic space (a.k.a. right anterior space, right subdiaphragmatic space) is a potential space that lies between the right lobe of the liver and the inferior surface of the diaphragm.
Gross anatomy
This is a subcompartment of the supracolic compartment. It reaches as far as the upper boundary of the bare area of the liver.
Boundaries
- superiorly: superior layer of the coronary ligament
- laterally: right triangular ligament
- medially: falciform ligament
- inferiorly: continuous with the right supramesocolic space
Communications
Anatomically it communicates inferiorly with rest of the supramesocolic compartment, and the right subhepatic space and the lesser sac through the epiploic foramen. But, the clinically important subphrenic abscesses are often concealed and confined to the space.
Related pathology
Intraperitoneal seeding of pelvic malignancies, particularly ovarian cancers, can occur in the right subphrenic and subhepatic spaces by transcoelomic spread up through the right paracolic gutter . Likewise, the right paracolic gutter also acts as a conduit for pelvic infections to track up into the right subphrenic and subhepatic spaces . Right subphrenic abscesses are often secondary to intra-abdominal sepsis (e.g. peritonitis, ruptured liver abscess, ruptured appendicular abscess), and may have an acute or chronic course. Gas accumulation within the space in a case of ruptured hollow viscera can be demonstrated radiologically free subdiaphragmatic gas.
