Lymphatic vessels and nodesof the abdominal cavity

In this note, we are going to discuss the main groups of lymph nodes in the abdominal cavity and the lymphatic drainage pathways from various tissues and organs.

Lymphatic vessels and nodes of the abdominal cavity

The abdominal cavity contains two major groups of lymph nodes:

Parietal lymph nodes
Visceral lymph nodes

The parietal lymph nodes collect lymph from the walls of the abdominal cavity, muscles, fasciae, and the parietal peritoneum. The primary groups of parietal lymph nodes include:

Inferior epigastric nodes, which are located within the sheath of the rectus abdominis muscle, along the course of the inferior epigastric vessels.

Inferior epigastric nodes are located along the highlighted artery

Lumbar nodes, which are found in the retroperitoneal space, along the aorta and the inferior vena cava.

These nodes receive lymph from the lower limbs, walls, organs of the pelvis, and abdominal cavity.

The lumbar nodes are further divided into:

Left (or para-aortic) lumbar nodes

Right (or caval) lumbar nodes

Intermediate lumbar nodes

The para-aortic nodes are classified into:

Lateral aortic nodes

Preaortic nodes

Retroaortic nodes

The caval nodes, depending on their location, are divided into:

Lateral caval nodes

Precaval nodes

Retrocaval nodes

The next large group of nodes – the inferior diaphragmatic nodes, are located along the inferior diaphragmatic vessels on the abdominal surface of the diaphragm. They collect lymph from the diaphragm and the diaphragmatic surface of the liver.

Visceral lymph nodes drain lymph from the internal organs, primarily those of the digestive system, and are located along the unpaired branches of the abdominal aorta.

The main groups of visceral lymph nodes include:

Gastric nodes

These nodes are found along the vessels of the lesser and greater curvatures of the stomach and are categorized as follows:

Left gastric nodes

Nodes around cardia

Right gastric nodes

Pyloric nodes

Right gastroomental nodes

Left gastroomental nodes

Efferent lymphatic vessels from the regional nodes of the stomach drain into the celiac nodes. In some cases, lymph may bypass the intermediate nodes and drain directly into the thoracic duct.

Pancreatic nodes are located along the superior border of the pancreas. They collect lymph from the pancreas.

Splenic nodes are found along the branches of the splenic artery. They drain lymph from the capsule of the spleen, pancreas, and partially from the stomach.

Pancreaticoduodenal nodes lie along the pancreaticoduodenal arteries and receive lymph from the duodenum and the head of the pancreas.

Hepatic nodes are situated within the hepatoduodenal ligament, following the common hepatic artery and portal vein. These nodes collect lymph from the liver.

Cystic nodes are positioned near the neck of the gallbladder, where they drain lymph directly from the gallbladder and the liver.

Celiac nodes are located near the celiac trunk and collect lymph from the stomach, pancreas, liver, spleen, and duodenum.

Superior mesenteric nodes are found between the layers of the mesentery of the small intestine, following the superior mesenteric artery.

These nodes drain lymph from the small intestine, cecum, ascending colon, and transverse colon. They are arranged in levels that correspond to the branching of the vessels, with central nodes located at the origin of the superior mesenteric artery.

Inferior mesenteric nodes are positioned along the inferior mesenteric artery. They collect lymph from the descending colon, sigmoid colon, and the upper rectum.

The superior and inferior mesenteric nodes also receive lymph from several groups of regional nodes, primarily located along the vessels supplying the corresponding sections of the intestine:

Ileocolic nodes collect lymph from the terminal portion of the ileum, as well as partially from the cecum and the appendix.

Cecal nodes drain lymph from the cecum and the appendix.
Right colic nodes collect lymph from the ascending colon.

Left colic nodes collect lymph from the descending colon.

Mesocolic nodes are found within the mesentery of the transverse colon and drain lymph from this region.

Occasionally, a chain of paracolic nodes is present along the ascending, transverse, and descending sections of the colon.

Sigmoid nodes collect lymph from the sigmoid colon.
Additionally, there are appendicular nodes, which drain lymph specifically from the appendix.

The lymph from the organs of the abdominal cavity drains into the visceral nodes and then into the parietal nodes. Among these, the lumbar nodes receive the largest volume of lymph. The efferent vessels of the lumbar nodes form the right and left lumbar trunks, which drain into the thoracic duct.

In approximately 25% of cases, the efferent vessels of the mesenteric nodes form an intestinal trunk,

which drains directly into the thoracic duct.

It is also important to note that in the distal part of the small intestine and the proximal part of the large intestine, there are clusters of lymphatic follicles known as aggregated lymphoid nodules or Peyer’s patches. These structures play a key role in the immune response of the intestine.

Aggregated lymphoid nodules / Peyer’s patches

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