Peritoneum. Omenta. Abdominal cavity

Peritoneum. Omenta. Abdominal cavityAnatomical features of the peritoneum. Abdominal cavity. Derivatives of the peritoneum. Mesentery, greater and lesser omentum, ligaments and folds.
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Abdominal cavity (cavitas abdominis) is the largest cavity of the human body. It is located between the thoracic cavity and the pelvis.

Peritoneum (peritoneum) is a serous coat lining the walls of the abdominal cavity and covering some organs located in it. It secretes and absorbs serous fluid.

The peritoneum is divided into 2 layers:

1. Parietal layer, which covers the internal surface of the abdominal wall

Peritoneum (peritoneum)
Peritoneum (peritoneum)
Peritoneum (peritoneum)
Peritoneum (peritoneum)
Peritoneum (peritoneum)
Peritoneum (peritoneum)

2. Visceral layer, which covers the organs of the abdominal cavity.

Visceral sheath (peritoneum viscerale)
Visceral sheath (peritoneum viscerale)

The space between the sheaths is called the peritoneal cavity (cavitas peritonealis). This cavity is filled with serous fluid.

Peritoneal cavity (cavitas peritonealis)
Peritoneal cavity (cavitas peritonealis)
Peritoneal cavity (cavitas peritonealis)
Peritoneal cavity (cavitas peritonealis)

The peritoneum forms various spaces inside the abdominal cavity, separating the organs from each other.

  • Abdominal cavity (cavitas abdominalis) is a space that is delimited by the endo-abdominal fascia (fascia endoabdominalis).
Endo-abdominal fascia (fascia endoabdominalis)
Endo-abdominal fascia (fascia endoabdominalis)
  • Space located behind the peritoneum is called the retroperitoneal space (spatium retroperitoneale).
Retroperitoneal space (spatium retroperitoneale)
Retroperitoneal space (spatium retroperitoneale)
Retroperitoneal space (spatium retroperitoneale)
Retroperitoneal space (spatium retroperitoneale)
  • Space located in the area of the urinary bladder is called the anteroperitoneal space (spatium anteroperitoneale).
  • Space located below the peritoneum is called the subperitoneal space (spatium subperitoneale)

There are three options for covering the visceral peritoneum of internal organs.

  • The intraperitoneal location means that the organ is covered with the peritoneum from all sides. Examples: stomach, ileum, jejunum, caecum, appendix, transverse colon, sigmoid colon, and initial part of the rectum.
  • The mesoperitoneal location means that the organ is covered with the peritoneum on three sides. Mesoperitoneal organs include the ascending colon, descending colon, the middle part of the rectum, liver, filled urinary bladder and gallbladder, as well as uterus.
  • The extraperitoneal location means that the organ is covered with the peritoneum on only one side.

Let’s consider a number of derivatives of the peritoneum.

  1. Ligaments of the peritoneum
  2. Mesenteries
  3. Omenta
  4. Folds

Mesenteries are double-sheath ligaments, or duplicators of the peritoneum, fixing the organ and serving as conductors of vessels and nerves. It should be remembered that the organ with the mesentery is always located intraperitoneally.

The root of the mesentery is the place where the mesentery of an organ is fixed to the posterior wall of the abdominal cavity.

Let’s take a closer look at where the roots of the mesenteries of various organs are located.

  • Root of the mesentery of the transverse colon (radix mesocolon transversum) begins on the right at the level of the 2nd lumbar vertebra and ends on the left at the level of the 1st lumbar vertebra.
  • Root of the mesentery of the jejunum and ileum (radix mesenterii) arises from the 2nd lumbar vertebra and ends in the projection of the right sacro-iliac joint.
  • Root of the mesentery of the sigmoid colon (radix mesocolon sigmoidei) is attached to the left at the level between the 4th and 5th lumbar vertebrae.
Root of the mesentery of the jejunum and ileum (radix mesenterii)
Root of the mesentery of the jejunum and ileum (radix mesenterii)
Root of the mesentery of the jejunum and ileum (radix mesenterii)
Root of the mesentery of the jejunum and ileum (radix mesenterii)
  • Root of the mesentery of the rectum (radix mesorecti) is attached at the level between the 1st and 3rd sacral vertebrae.
  • Root of the mesentery of the vermiform process (radix mesoappendicis) is attached to the terminal part of the ileum.

The omentum is an elongated mesentery of the stomach, between the sheaths of which there are accumulations of adipose tissue in the form of lobules, as well as plexuses of blood vessels.

There are two omenta in the human body:

  1. Greater omentum
  2. Lesser omentum

Let’s consider them in greater detail.

The lesser omentum (omentum minus) is a duplication of the peritoneum stretched between the liver, the small curvature of the stomach and the superior part of the duodenum.

Lesser omentum (omentum minus)
Lesser omentum (omentum minus)

It consists of two ligaments that pass into one another:

  • Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
Hepatogastric ligament (lig. hepatogastricum)
  • Hepatoduodenal ligament (lig hepatoduodenale). The portal vein, proper hepatic artery, common bile duct, lymphatic vessels, and nerves pass through its thickness.
Hepatoduodenal ligament (lig hepatoduodenale)
Hepatoduodenal ligament (lig hepatoduodenale)
Hepatoduodenal ligament (lig hepatoduodenale)
Hepatoduodenal ligament (lig hepatoduodenale)

Greater omentum (omentum majus) is an elongated dorsal mesentery of the stomach.

Greater omentum (omentum majus)
Greater omentum (omentum majus)
Greater omentum (omentum majus)
Greater omentum (omentum majus)
Greater omentum (omentum majus)
Greater omentum (omentum majus)

It consists of three ligaments:

  • Gastrocolic ligament (lig. gastrocolicum), which connects the stomach and transverse colon.
Gastrocolic ligament (lig. gastrocolicum)
Gastrocolic ligament (lig. gastrocolicum)
Gastrocolic ligament (lig. gastrocolicum)
Gastrocolic ligament (lig. gastrocolicum)
  • Gastrosplenic ligament (lig. gastrolienale / gastrosplenicum), which connects the stomach and spleen.
Gastrosplenic ligament (lig. gastrolienale / gastrosplenicum)
Gastrosplenic ligament (lig. gastrolienale / gastrosplenicum)
Gastrosplenic ligament (lig. gastrolienale / gastrosplenicum)
Gastrosplenic ligament (lig. gastrolienale / gastrosplenicum)
  • Gastroprhenic ligament (lig. gastrophrenicum), which connects the stomach and the diaphragm.
Gastroprhenic ligament (lig. gastrophrenicum)
Gastroprhenic ligament (lig. gastrophrenicum)
Gastroprhenic ligament (lig. gastrophrenicum)
Gastroprhenic ligament (lig. gastrophrenicum)

Peritoneal folds are duplications of the parietal peritoneum formed by vessels, ducts, ligaments, or fat deposits passing under it.

The following structures are located on the anterior abdominal wall:

  • Median umbilical fold (plica umbilicalis mediana), which contains the median umbilical ligament (lig. umbilicale medianum), which is a closed urinary duct of the fetus (urachus).
Median umbilical fold (plica umbilicalis mediana)
Median umbilical fold (plica umbilicalis mediana)
  • Medial umbilical fold (plica umbilicalis medialis) contains the medial umbilical ligament (lig. umbilicale medianum), which is a closed umbilical artery (a. umbilicalis).
Medial umbilical fold (plica umbilicalis medialis)
Medial umbilical fold (plica umbilicalis medialis)
  • Lateral umbilical fold (plica umbilicalis lateralis) contains the inferior epigastric arteries and veins.
Lateral umbilical fold (plica umbilicalis lateralis)
Lateral umbilical fold (plica umbilicalis lateralis)

On the internal surface of the anterior abdominal wall, above the inguinal ligament, three pairs of pits are present between the above mentioned folds

  • Supravesical fossae (fossa supravesicalis), which are located on the sides of the medial umbilical fold.
Supravesical fossae (fossa supravesicalis)
Supravesical fossae (fossa supravesicalis)
  • Medial inguinal fossa (fossa inguinalis medialis), which is located medial to the lateral umbilical fold and corresponds to the external opening of the inguinal canal.
Medial inguinal fossa (fossa inguinalis medialis)
Medial inguinal fossa (fossa inguinalis medialis)
  • Lateral inguinal fossa (fossa inguinalis lateralis), which is located laterally to the lateral umbilical fold and corresponds to the internal opening of the inguinal canal.
Lateral inguinal fossa (fossa inguinalis lateralis)
Lateral inguinal fossa (fossa inguinalis lateralis)

Under the inguinal ligament, there is another fossa called the femoral fossa (fossa femoralis). It corresponds to the internal opening of the femoral canal.

Let’s go even lower, into the lesser pelvis. The following structures are present in the lesser pelvis:

  • Rectovesical fold (plica rectovesicalis) in men
  • Recto-uterine fold (plica rectouterina) and vesico-uterine fold (plica vesicouterina) in women.

There are also fossae (or depressions) on the posterior wall of the peritoneal cavity. Retroperitoneal hernias may form in them.

The superior duodenal recess (recessus duodenalis superior)

Lateral inguinal fossa (fossa inguinalis lateralis)
Lateral inguinal fossa (fossa inguinalis lateralis)

and the inferior duodenal recess (recessus duodenalis inferior) are located near the duodenojejunal flexure

Inferior duodenal recess (recessus duodenalis inferior)
Inferior duodenal recess (recessus duodenalis inferior)

Behind the cecum, there is the retrocaecal recess (recessus retrocaecalis).

Retrocaecal recess (recessus retrocaecalis)
Retrocaecal recess (recessus retrocaecalis)

An intersigmoid recess (recessus intersigmoideus) is located near the sigmoid colon.

Intersigmoid recess (recessus intersigmoideus)
Intersigmoid recess (recessus intersigmoideus)

In addition, the so-called floors can be distinguished in the peritoneal cavity. According to the conventional classification, there are two floors: upper and lower. The border between them is the transverse colon and its mesentery.

There are three so-called bursae on the upper floor:

The hepatic bursa (bursa hepatica), which contains the right lobe of the liver. It has a subphrenic recess (recessus subphrenicus)

Subphrenic recess (recessus subphrenicus)
Subphrenic recess (recessus subphrenicus)
Subphrenic recess (recessus subphrenicus)
Subphrenic recess (recessus subphrenicus)

and a subhepatic space (recessus subhepaticus)

Subhepatic space (recessus subhepaticus)
Subhepatic space (recessus subhepaticus)
Subhepatic space (recessus subhepaticus)
Subhepatic space (recessus subhepaticus)

The pregastric bursa (bursa pregastrica) is located anteriorly to the stomach and lesser omentum

The omental sac (bursa omentalis) is located posteriorly to the stomach and lesser omentum.

Omental sac (bursa omentalis)
Omental sac (bursa omentalis)
Omental sac (bursa omentalis)
Omental sac (bursa omentalis)
Omental sac (bursa omentalis)
Omental sac (bursa omentalis)

It contains three recesses:

Superior omental recess (recessus omentalis superior)

Superior omental recess (recessus omentalis superior)
Superior omental recess (recessus omentalis superior)
Superior omental recess (recessus omentalis superior)
Superior omental recess (recessus omentalis superior)

Inferior omental rece (recessus omentalis inferior)

Inferior omental rece (recessus omentalis inferior)
Inferior omental rece (recessus omentalis inferior)
Inferior omental rece (recessus omentalis inferior)
Inferior omental rece (recessus omentalis inferior)

Splenic recess (recessus lienalis)

Splenic recess (recessus lienalis)
Splenic recess (recessus lienalis)
Splenic recess (recessus lienalis)
Splenic recess (recessus lienalis)

The omental bursa communicates with the hepatic bursa by the omental (or Winslow) foramen (foramen epiploicum)

Splenic recess (recessus lienalis)
Splenic recess (recessus lienalis)

In the inferior floor of the peritoneal cavity, there are two lateral canals and two mesenteric sinuses.

Right lateral canal (canalis lateralis dexter) is located between the right wall of the abdomen and the ascending colon.

Left lateral canal (canalis lateralis sinister) is located between the left wall of the abdomen and the descending colon.

The root of the mesentery of the small intestine divides the lower floor into the right mesenteric sinus (sinus mesentericus dexter)

Right mesenteric sinus (sinus mesentericus dexter)
Right mesenteric sinus (sinus mesentericus dexter)

and the left mesenteric sinus (sinus mesentericus sinister).

Left mesenteric sinus (sinus mesentericus sinister)
Left mesenteric sinus (sinus mesentericus sinister)

The right sinus is closed, and the left one communicates with the pelvic cavity inferiorly.

Where the peritoneum passes from the bladder to the rectum, men have the recto-vesical pouch (excavatio rectovesicalis)

Recto-vesical pouch (excavatio rectovesicalis)
Recto-vesical pouch (excavatio rectovesicalis)

In women, the peritoneum, passing from the bladder to the uterus, forms the vesico-uterine pouch (excavatio vesicouterina),

Vesico-uterine pouch (excavatio vesicouterina)
Vesico-uterine pouch (excavatio vesicouterina)

and moving from the uterus to the rectum it forms the recto-uterine pouch (excavatio rectouterina)

Recto-uterine pouch (excavatio rectouterina)
Recto-uterine pouch (excavatio rectouterina)
Dictionary

Peritoneum. Omenta. Abdominal cavity

Peritoneum
peritoneum
Abdominal cavity
cavitas abdominalis
Endo-abdominal fascia
fascia endoabdominalis
Retroperitoneal space
spatium retroperitoneale
Anteroperitoneal space
spatium anteroperitoneale
Subperitoneal space
spatium subperitoneale
Peritoneal cavity
cavitas peritonei
Root of the mesentery of the transverse colon
radix mesocolon transversum
Root of the mesentery of the jejunum and ileum
radix mesenterii
Root of the mesentery of the sigmoid colon
radix mesocolon sigmoidei
Root of the mesentery of the rectum
radix mesorecti
Root of the mesentery of the vermiform process
radix mesoappendicis
Lesser omentum
omentum minus
Hepatogastric ligament
lig. hepatogastricum
Hepatoduodenal ligament
lig hepatoduodenale
Greater omentum
omentum majus
Gastrocolic ligament
lig. gastrocolicum
Gastrosplenic ligament
lig. gastrolienale
Gastrophrenic ligament
lig. gastrophrenicum
Median umbilical fold
plica umbilicalis mediana
Median umbilical ligament
lig. umbilicale medianum
Urinary duct of the fetus
urachus
Medial umbilical fold
plica umbilicalis medialis
Medial umbilical ligament
lig. umbilicale mediale
Umbilical artery
a. umbilicalis
Lateral umbilical fold
plica umbilicalis lateralis
Supravesical fossa
fossa supravesicalis
Medial inguinal fossa
fossa inguinalis medialis
Lateral inguinal fossa
fossa inguinalis lateralis
Femoral fossa
fossa femoralis
Rectovesical fold
plica rectovesicalis
Recto-uterine fold
plica rectouterina
Vesico-uterine fold
plica vesicouterina
Superior duodenal recess
recessus duodenalis superior
Inferior duodenal recess
recessus duodenalis inferior
Retrocaecal recess
recessus retrocaecalis
Intersigmoid recess
recessus intersigmoideus
Subphrenic space
recessus subphrenicus
Subhepatic space
recessus subhepaticus
Pregastric bursa
bursa pregastrica
Omental bursa
bursa omentalis
Superior omental recess
recessus omentalis superior
Inferior omental recess
recessus omentalis inferior
Splenic recess
recessus lienalis
Omental foramen
foramen epiploicum
Right lateral canal
canalis lateralis dexter
Left lateral canal
canalis lateralis sinister
Right mesenteric sinus
sinus mesentericus dexter
Left mesenteric sinus
sinus mesentericus sinister
Rectovesical pouch
excavatio rectovesicalis
Vesico-uterine pouch
excavatio vesicouterina
Recto-uterine pouch
excavatio rectouterina
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