Anatomy of peritoneum and its related diseases

3.  The peritoneum is a thin,continuous,and
glistening serous membrane that lines the
abdominal and pelvic cavities and clothes the
visceras.
 It consists of two continuous layers
 Parietal peritoneum:lines the abdominopelvic
wall
 Visceral peritoneum:investing the visceras

5. PERITONEAL CAVITY
The potential space b/w
the visceral and parietal
peritoneum is called the
peritoneal cavity.
In males this is a closed
space,but in females
there is communication
with the exterior
through uterine
tubes,uterus and vagina.

6.  The peritoneal cavity is the largest cavity
divided into 2 parts
 Greater sac:extends from diaphragm down
into the pelvis
 Lesser sac:lies behind the stomach.
 These sacs are in free communication
through an oval window called epiploic
foramen, foramen of winslow.

8.  Anteriorly:portal vein,hepatic artery,and bile
duct
 Posteriorly:IVC,right crus of diaphragm
 Superiorly:caudate lobe of liver
 Inferiorly:ist part of duodenum

10.  Intraperitoneal organs: totally covered with
visceral peritoneum.e.g
stomach,jejunum,ileum,spleen,transverse
part of colon .
 Retroperitoneal organs: lies behind the
peritoneum and partially coverd by visceral
peritoneum.e.g pancreas,ascending and
descending parts of the colon and kidneys.
 In reality no organ is within the the peritoneal
cavity.

12. DESCRIPTIVE
TERMS FOR
PERITONEUM
MESENTERY:
Double layer of
peritoneum
connecting the
organs to the
posterior
abdominal wall
e.g mesentery of
small
intestine,transver
se and sigmoid
mesocolon

13. OMENTUM
A double layered fold of peritoneum
that passes from the stomach and
the proximal part of duodenum to
the adjacent organs in the
abdominal cavity.
Lesser omentum: connects the
lesser curvature of stomach and
proximal part of duodenm to the
liver.
Greater omentum: is a prominent
fold that hangs from the greater
curvature of the stomach and
duodenum and folds back and
attaches to the anterior surface of
the transverse colon.

14. PERITONEAL LIGAMENTS
Double layer of peritoneum that
connects an organ with another
organ or to the abdominal wall.
LIVER: is connected to the
Anterior Abdominal wall by
falciform ligament,
To the Stomach by the
hepatogastric ligament,
And to the duodenum by the
hepatoduodenal ligament.

15. CONTD…
STOMACH: is connected to the
Inferior surface of the
diaphragm by the gastrophrenic
ligament
Spleen by the gastrosplenic
ligament
Transverse colon by the
gastrocolic ligament

16. PERITONEAL
FOLDS
A reflection of
peritoneum that is
raised from the
abdominal wall by
underlying
structures.e.g
Median umbilical
fold:median umbilical
ligament
Two medial umbilical
folds:medial umbilical
ligaments
Two lateral umbilical
folds:inf.epigastric
vessels

17. Peritoneal Recess
A pouch of
peritoneum that is
formed by a
peritoneal fold.e.g
Inferior recess of
omental bursa
Supravesical and
medial and lateral
inguinal fossae
b/w the umbilical
folds

18. COMPARTMENTS
The transverse
mesocolon divides
the abdominal
cavity into:
Supracolic
compartment
containing stomach
Infracolic
compartment
containing small
intestine ,ascending
and descending
colon

19. CONTD…
The infracolic
compartment lies
posterior to greater
omentum and is
divided into right
and left infracolic
spaces by
mesentery of small
intestine.
Free comunication
occurs b/w these
compartments
through paracolic
gutters

20. CLINICAL
CONSIDERATIONS
ASCITES:
Excessive accumulation of the
peritoneal fluid within the
peritoneal cavity.
Causes:hepatic
cirrhosis,malignantdisease,co
ngestive heart failure.
Symptoms:shortness of
breath,abdominal
pain,bloating
Tests:paracentesis(abdominal
tap)
Treatment:diuretics.antibiotic
s.

21. PERITONEAL
PAIN
FROM THE
PARIETAL
PERITONEUM:
Parietal peritoneum
linning the anterior
abdominal wall is
supplies by T6-T12
and L1 spinal
nerves. Abdominal
pain is therfore of
somatic type and
can be localized.

22. FROM THE VISCERAL
PERITONEUM:
The visceral peritoneum
including the
mesenteries is
innervated by
autonomic afferent
nerves.
Stretch caused by
overdistention of
viscus,or pulling on a
mesentery give rise to
sensation of pain.pain
arising from an
abdominal viscus is
poorly localized.