Spatial relationship between the retroperitoneal fasciae on the dorsal side of the pancreas and the nerves.

Objective: The fascia on the dorsal surface of the pancreatic head is referred to as the fascia of Treitz, whereas the one on the body and tail is termed the fascia of Toldt. These fasciae seem to influence the course of the nerves originating from the celiac plexus and distributed to the pancreas. Therefore, this study aimed to clarify the spatial relationship between the fasciae and nerves. Methods: Eight cadavers (age at death: 88.8 years) were used for this study. Five were macroscopically examined, and three were sectioned serially into 8-µm thick slices at 0.25-mm intervals. Two of the three were 3D reconstructed using TRI/3DSRF? Results: The nerves from the celiac plexus did not penetrate the fasciae of Treitz and Toldt. They converged and passed through the gap between the fasciae around the celiac trunk (CeT) and superior mesenteric artery (SMA) roots towards the pancreas. This gap between the fasciae gradually narrower caudally to the SMA root and closed between the SMA and inferior mesenteric artery (IMA) roots. In other words, the fasciae of Treitz and Toldt got closer, and the boundary between them disappeared inferior to the SMA root. Then, the overlapped part of these fasciae covered the aorta's anterior surface between the SMA and IMA roots. Conclusion: Our findings suggest that the nervous pathway connecting the retroperitoneal region and peritoneal organs is not just the area between the fasciae of Treitz and Toldt but the very narrow and confined gap created by these fasciae primarily centred around the CeT and SMA roots. [ABSTRACT FROM AUTHOR]