The formation of abdomino-perineal sacs by the fasciae of Scarpa and Colles, and their clinical significance

Abstract

It has been shown that the membranous layer of the subcutaneous tissue, known as Scarpa's fascia, is confined to an oval area on each side of the abdominal wall. By its attachment to the deep fascia it encloses an obliquely directed oval sac which extends into the perineum by three pocket-like diverticulae. The fascial extension which forms the pockets is known as the fascia of Colles. 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 significance of the fascial arrangements in relation to urinary extravasation is discussed, and also the relationship of the intermediate pocket to an indirect inguinal hernia.