THE FORMATION OF ABDOMINO-PERINEAL SACS BY THE FASCIAE OF SCARPA AND COLLES, AND THEIR CLINICAL-SIGNIFICANCE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 138  (JUN) , 603-616
Abstract
Studies by dissection and by radiological investigation showed that the membranous layer of the subcutaneous tissue of the lower abdominal wall (Scarpa''s fascia) is confined to an oval area on each side, and since its margins are attached to the underlying deep fascia it encloses an obliquely directed oval sac, open to the perineum. The perineal extension (known as Colles'' fascia) is in the form of 3 pockets. In females, the pockets are smaller and commonly occupied by adhesions. Medially, the sac blends with the fundiform ligament, so that the sacs do not communicate with each other or with the interfascial space deep to the penile dartos. Laterally, the inferior margin creates the crease-line of the groin by its attachment to the fascia lata. Between these attachments the pockets arise from the sac. The lateral pocket continues into the superficial perineal pouch. The medial pocket, together with the intermediate, occupies the scrotum or labium majus. The intermediate pocket is associated with the spermatic cord or the round ligament of the uterus and blends with their coverings posteriorly. In the male it terminates just above the testis. The sac of an indirect inguinal hernia invaginates the cord pocket posteriorly: consequently, the pocket contains it and forms its outermost covering. When the penile shaft becomes invaded by extravasated urine following urethral rupture, the extravasate apparently enters the interfascial penile space via the breach in the fasciae, and not from the scrotum around the root of the shaft.