describes about peritoneal cavity and clinical importance of it. it describes in deatils about lesser sac, greater sac, pouch of Morrison, pouch of Douglas.

1. Peritoneum II
To -MBBS 2nd Year
Dr Laxman Khanal
Asst prof. department of Anatomy
BPKIHS, Dharan
06-09-2016

2. Q. All are the derivatives of dorsal mesogastrium except
a. Greater omentum
b. Gastro splenic ligament
c. Splenorenal ligament
d. Lesser omentum
Q. Which of the following organ is secondary
retroperitoneal organ?
a. Kidney
b. Suprarenal gland
c. Abdominal aorta
d. Duodenum

3. Q. Most dependent peritoneal space in supine position is-
a. Pouch of Douglas
b. Lesser sac
c. Pouch of Morrison
d. Rectovesicle pouch
Q. All of the following structure form the posterior
boundary of Epiploic foramen except.
a. IVC
b. Rt suprarenal gland
c. Lt suprarenal gland
d. T12 vertebra

5. Lesser Sac

6. Parts of lesser sac
1. Superior recess
2. Inferior recess
3. Splenic recess
4. Omental bursa

7. Lesser sac
Position: Behind the lesser omentum and stomach
Walls
• Superior－peritoneum which covers the caudate lobe of
liver and diaphragm
• Anterior: lesser omentum, peritoneum of posterior wall
of stomach, and anterior two layers of greater omentum
• Inferior: Continuative area of anterior and posterior two
layers of greater omentum
• Posterior: Posterior two layers of greater omentum,
transverse colon and transverse mesocolon, peritoneum
covering pancreas, left kidney and suprarenal gland

13. Supra and infracolic compartment
• The transverse mesocolon divides the abdominal
cavity into a supracolic compartment, containing the
stomach, liver, and spleen, and an infracolic
compartment, containing the small intestine and
ascending and descending colon.
• The infracolic compartment is divided into right and
left infracolic spaces by the mesentery of the small
intestine.
• Free communication occurs between the supracolic
and the infracolic compartments through the
paracolic gutters

14. Supracolic
• Rt/Lt subphrenic space
• Right subhepatic space
(hepatorenal pouch)
• Left subhepatic space
(Lesser Sac)
Infracolic
• Rt/Lt infracolic space
• Paracolic gutters

15. Subphrenic space
Subhepatic space
• Rt/Lt subphrenic space
• Right subhepatic space
(hepatorenal pouch)
• Left subhepatic space
(Lesser Sac)

16. Rt subhepatic space
(Hepatorenal pouch)
Lt subhepatic space
(Lesser Sac)

17. Inf layer of coronary
ligaments
Open to Rt paracolic
gutter
Rt lobe of liver Rt Kidney
Morrison’s Pouch
Hepatorenal pouch
Rt subhepatic pouch

18. • Most dependent part of the peritoneal cavity in supine
position
• Most common site of subphrenic abscess

19. Infracolic
compartment
• Rt/Lt infracolic space
• Paracolic gutters

21. Pelvic part of peritoneal cavity
• Vesicouterine pouch
• Rectouterine pouch

22. • Most dependent part in sitting or
standing position.
• Most common site of pelvic abscess.

25. Peritoneal recesses
• These are small spaces of peritoneal cavity
with in large peritoneal cavity. These are
guarded by folds which contain blood vessel.
• Duodenal recesses
• Caecal recess
• Intersigmoid recesses

26. • Duodenal recesses
• Exist around the fourth part of the duodenum and the
duodenojejunal junction forming a number of named recesses.

27. Paracecal recess
• Superior ileocecal recess (ant cecal artery)
• Inferior ileocecal recess (avascular)
• Retrocecal recess (contains appendix)

28. Urachus
Umb artery
Inf Epigastric vesses
Folds and fossa of anterior abdominal wall

29. Folds and fossas of anterior abdominal wall
• Median umbilical fold －
contain the remnant of
urachus (median umbilical
ligaments)
• Medial umbilical fold －
contains remnants of the
umbilical arteries (medial
umbilical ligaments)
• Lateral umbilical fold
contains the inferior
epigastric vessels
Supravesical fossa
Medial inguinal fossa
Lateral inguinal fossa

31. Sites of paracentesis

32. Peritoneal dialysis VP Shunt