Anterior surface of kidney

The anterior surface of each kidney is convex, and looks forward and lateralward. Its relations to adjacent viscera differ so completely on the two sides that separate descriptions are necessary.

• Anterior surface of right kidney: A narrow portion at the upper extremity is in relation with the right suprarenal gland. A large area just below this and involving about three-fourths of the surface, lies in the renal impression on the inferior surface of the liver, and a narrow but somewhat variable area near the medial border is in contact with the descending part of the duodenum. The lower part of the anterior surface is in contact laterally with the right colic flexure, and medially, as a rule, with the small intestine. The areas in relation with the liver and small intestine are covered by peritoneum; the suprarenal, duodenal, and colic areas are devoid of peritoneum.

• Anterior surface of left kidney: A small area along the upper part of the medial border is in relation with the left suprarenal gland, and close to the lateral border is a long strip in contact with the renal impression on the spleen. A somewhat quadrilateral field, about the middle of the anterior surface, marks the site of contact with the body of the pancreas, on the deep surface of which are the lienal vessels. Above this is a small triangular portion, between the suprarenal and splenic areas, in contact with the postero-inferior surface of the stomach. Below the pancreatic area the lateral part is in relation with the left colic flexure, the medial with the small intestine. The areas in contact with the stomach and spleen are covered by the peritoneum of the omental bursa, while that in relation to the small intestine is covered by the peritoneum of the general cavity; behind the latter are some branches of the left colic vessels. The suprarenal, pancreatic, and colic areas are devoid of peritoneum.