Peritoneum

l General Introduction

l Relations Between Peritoneum and

Visceral Organs in Abdominal and

Pelvic Cavities

l Structures Coming from Peritoneum

l Recess and Pouch

 Peritoneum

General Introduction

Definition
The peritoneum is the most large serous membrane lining
the abdominal cavity and covering the surfaces of the viscera
located in the abdominal cavity and pelvic cavity. .
It is semitransparent, thin and smooth and is composed of
fibrous tissue and mesothelial cells, which secrete a serous
fluid to lubricate the visceral surface, thus allowing free
movements of viscera.
General Introduction

Division

Parietal peritoneum lines the inner

surface of the abdominal and pelvic
cavities and the inferior surface of the
diaphragm...
Visceral peritoneum covers the
outer surface of the viscera.
General Introduction

Peritoneal cavity is the space

between the parietal peritoneum and
the visceral peritoneum. It is irregular in
shape. In male, the peritoneal cavity is
a closed sac. In the female, the
peritoneal cavity communicates with the
exterior through the uterine tube,
uterus and vagina.
Relations Between Peritoneum and Visceral
Organs in Abdominal and Pelvic Cavities

Intraperitoneal organs are covered by peritoneum on every surfaces,

such as the stomach, the upper of duodenum, jejunum, ileum, cecum,
vermiform appendix, transverse colon, sigmoid colon, spleen, ovary,
uterine tube, etc. .
interperitoneal organs are covered by peritoneum on most surfaces,
such as liver, gallbladder, ascending colon, descending colon, the
superior segment of rectum, uterus, urinary bladder, etc.
Extraperitoneal(retroperitoneal) organs are covered by peritoneum
on one surface, such as the kidney, suprarenal gland, ureter, pancreas,
the descending and inferior part of duodenum, the inferior segment of
rectum, etc.
Relations Between Peritoneum and Visceral
Organs in Abdominal and Pelvic Cavities

extraperitoneal organ

interperitoneal organ

intraperitoneal organ
peritoneal cavity
Relations Between Peritoneum and Visceral
Organs in Abdominal and Pelvic Cavities

liver

stomach

transverse
colon

jejunum

ileum
uterus
urinary bladder
Relations Between Peritoneum and Visceral
Organs in Abdominal and Pelvic Cavities

suprarenal
gland

kidney

pancreas kidney

peritoneum
Structures Coming from Peritoneum

Omentum

Mesenteries and mesocolons

ligaments
Omentum
Lesser Omentum

It is part of the peritoneum, which

gastrohepatic
extends from the porta hepatis to ligament
the lesser curvature of the stomach hepatoduodenal
ligament
and the first 2 cm of the duodenum.
The portion of the lesser omentum
between the liver and the stomach
is called the hepatogastric ligament,
and the portion between the liver
and the duodenum is named the
hepatoduodenal ligament. .
Omentum
Lesser Omentum

The hepatoduodenal ligament

contains the proper hepatic hepatoduodenal
ligament
artery (left and anterior ), the

common bile duct (right and anterior ) and the hepatic portal
vein (posterior). The hepatogastric ligament contains the left
gastric vessels and the right gastric vessels along the lesser
curvature of the stomach.
Omentum
Greater Omentum

It is part of the peritoneum,

which hangs down from the greater
omentum
greater curvature of the stomach
like an apron and covers the
loops of intestines.
Greater omentum
Four layers
Anterior two layers descend from
greater curvature of stomach
superior part of duodenum and
hang downward in front of small
intestine, and then turn upward
forming posterior two layers attach
to transverse colon.

The part of the peritoneal cavity

between the second and third
layers is called the lesser sac or
omental bursa.
Omentum Greater omentum

Functions
It is a storehouse of fat.
It protects the peritoneal cavity against infection
because of the presence of macrophages.
It also limits the spread of infection by moving to the site
of infection and sealing it off from the surrounding areas.
On this account, the greater omentum is also known as
the policeman of the abdominal cavity.
Omentum
Lesser Sac or Omental Bursa epiploic
foramen
It is a large recess of the peritoneal omental
bursa
cavity behind the stomach, the lesser
omentum and the caudate lobe of the
liver. It is closed all around, except in
the upper part of its right border
where it communicates with the
greater sac through the epiploic
foramen. .
Omentum
Lesser Sac or Omental Bursa
epiploic
foramen
Boundaries omental
bursa
Anterior wall: caudate lobe of the liver;
lesser omentum; posterior surface of
stomach; anterior two layers of the
greater omentum
posterior wall: structures forming the
stomach bed; posterior two layers of the
greater omentum
Omentum
Lesser Sac or Omental Bursa
epiploic
foramen
Boundaries: omental
bursa
Upper border: peritoneum covering
the caudate lobe of liver and the
inferior surface of diaphragm
Inferior border: continuation of the
second layer and the third layer of
the greater omentum
Omentum
Lesser Sac or Omental Bursa

gastrosplenic ligament
Left border:
spleen; gastrosplenic ligament; omental
bursa
omental
splenorenal ligament foramen
Right border:
omental foramen, by which the
lesser sac communicates with the
splenorenal ligament
other part of the peritoneal cavity.
Omentum
Omental foramen
(Epiploic foramen)

epiploic omental
foramen bursa
Mesenteries

Mesentery of the small intestine

Transverse mesocolon

Mesoappendix

Sigmoid mesocolon
Mesenteries
Mesentery of small intestine—
a broad, and fan-shaped double layers
transverse
suspends the jejunum and ileum from mesocolon

the posterior abdominal wall. mesentery

Radix of mesentery— the part of the

mesentery attaching to the posterior
abdominal wall, 15 cm,
extends from the left side of 2nd
lumbar vertebra to the right sacroiliac
joint.
Mesenteries
Transverse mesocolon— connects
transverse colon to the dorsal
abdominal wall. radix of
transverse
mesocolon
Mesoappendix— a triangular-shaped
radix of
double layers. The appendicular artery mesentery

passes through its free border. radix of

mesosigm
oid
Sigmoid mesocolon— double layers to
connect the sigmoid to the lower left
abdomen.
mesoappendix
Ligament
Ligaments of liver
hepatogastric
Hepatogastric ligament ligament
hepatoduodenal
Hepatoduodenal ligament ligament

Falciform ligament
Coronary ligament
Triangular ligament
coronary
ligament

falciform
ligament

right
triangular left triangular
ligament ligament
Ligament
Ligaments of spleen Hepatogastric
ligament
Hepatoduodenal
Gastrosplenic ligament ligament
Gastrosplenic
ligament Gastrocolic
Splenorenal ligament ligament

Phrenicosplenic ligament

Ligaments of stomach

Gastrosplenic ligament
Hepatogastric ligament
Gastrocolic ligament
Splenorenal
Gastrophrenic ligament ligament
 Recess and Pouch

The hepatorenal recess is situated

Hepatorenal
between the right hepatic lobe and recess

right kidney, which is the lowest

place of the peritoneal cavity when
person lies on the back. The ascites
is easy to accumulate in the
hepatorenal recess.
Recess and Pouch

Epiploic Omental
forament bursa

Hepatorenal
recess
Recess and Pouch
The peritoneal pouch—is mainly situated
in the pelvic cavity. Between the bladder
and rectum, the peritoneum forms in the
Rectovesical pouch
male the rectovesical pouch. In the
female the peritoneum is reflected from
the bladder onto the uterus, forming the
vesicouterine pouch. Then it extends to
the rectum as the rectouterine pouch, or
pouch of Douglas. When people is in Rectouterine pouch

sitting or standing position, both the

rectovesical pouch in the male and the
rectouterine pouch in the female are the
lowest place of the peritoneal cavity. Vesicouterine pouch
 Summary

We should pay much attention to these key points :

(1) The division and function of peritoneum; the deference between the
peritoneal cavity and abdominal cavity

(2) The extraperitoneal organs, the intraperitoneal organs, and the peritoneal
interposition organs.

(3) The lesser omentum; the forming and function of the greater omentum; the
position and communication of omental bursa.

(4) How many kinds of intestine have the mesenterium?

(5) The ligaments of liver, spleen, and stomach

(6) The hepatorenal recess; the rectovesical pouch; the rectouterine pouch