Anterior surface of suprarenal gland

The anterior surface of the suprarenal (adrenal) gland is the forward-facing aspect of the gland that is in direct contact with adjacent abdominal viscera and vessels. Its anatomical relations differ between the right and left sides.

Right suprarenal gland

The right adrenal gland is pyramidal in shape and sits posteromedial to the right lobe of the liver and posterior to the inferior vena cava (IVC). Its anterior surface has two distinct areas:

• A medial area that lies directly behind the IVC. Cadaveric studies show the right adrenal extends behind the IVC by an average of approximately 8 mm.

• A lateral area that is in contact with the bare area of the right lobe of the liver, separated only by parietal peritoneum.

The right adrenal vein drains from the anterior surface of the gland directly into the posterolateral aspect of the IVC, making this surface a critical landmark during adrenalectomy.

Left suprarenal gland

The left adrenal gland is semilunar (crescent-shaped) and lies on the superomedial aspect of the left kidney, lateral to the aorta. Its anterior surface is related to:

• The body and tail of the pancreas and the splenic artery, which cover the anterior surface.

• The splenic vein, which also courses along this surface.

• The stomach (via the omental bursa) in its upper portion, and the splenic flexure of the colon inferolaterally.

In cadaveric dissections, the anterior surface of the left suprarenal gland has been found to be totally covered by the body of the pancreas and the splenic vessels.