Purpose or Case Report: To review the anatomy of the Space of Retzius and to highlight the array of disorders that can occur in this space in the pediatric population. These disorders present as abdominal pain and might be missed or misdiagnosed without paying attention to this space and knowing the differential and differentiating factors of pathology that are found there.
Methods & Materials: Retrospective review of cases from 2007-2021 involving pathology in the Space of Retzius.
Results: We present a series of patients age 3 – 18 years with a variety of pathologies in the Space of Retzius, imaged with ultrasound, CT, or MRI. Examples of infectious or inflammatory conditions include a 15 yo female with an infected urachal remnant and a 3 yo female undergoing evaluation for appendicitis found to have pubic osteomyelitis with abscess in the Space of Retzius. A case of traumatic extraperitoneal bladder rupture will be reviewed. A case of pelvic sarcoma illustrates the potential neoplastic conditions within the space. The review will utilize a case-based approach to highlight the relevant findings and review important anatomic landmarks.
Conclusions: Pathology in the Space of Retzius can easily be missed, particularly by ultrasound, and the various etiologies for abdominal pain in this space can be difficult to differentiate from each other. Awareness of these etiologies when scanning and interpreting the findings is essential for timely diagnosis.