PERITONEAL FOLDS- LESSER OMENTUM & GREATER OMENTUM

PERITONEAL FOLDS

• Peritoneal folds serve as pathways for neurovascular structures to reach the organs from abdominal wall.

Name of the peritoneal fold may be as follows:

• Peritoneal folds attach to stomach are called Omenta: Lesser omentum & Greater omentum.

• Peritoneal fold suspending intestine is called mesentry.

• Folds of peritoneum connecting organs to rach other or to abdominal wall are called Ligaments.

PERITONEAL FOLD	CONTENTS
Greater omentum	Right & left gastroepiploic vessels
Lesser omentum Right free margin Along lesser curvature	Hepatic artery, portal vein, bile duct Right & left gastric vessels
Mesentry	Superior mesenteric artery
Transverse mesocolon	Middle colic artery
Sigmoid misocolon	Sigmoid & superior rectal vessels

 OMENTA

1). GREATER OMENTUM

• It is large 4 layered peritoneal fold hanging down like an apron from greater curvature.

• Anterior two layers descend from greater curvature of stomach to a variable extent, & fold upon themselves to form posterior two layers, i.e first layer becomes the fourth layer & second layer becomes third layer.

• The part of the peritoneal cavity called lesser sac b/w 2nd & 3rd layer gets obliterated, except for aboit 2.5cm below the greater curvature of stomach.

• Greater omentum contains the right & left gastroepiploic vessels which anastomose with each other in the interval b/w the first two layers.

• Greater omentum acts as storehouse of fat.

• Greater omentum is generally referred to as “policeman of abdomen” because it adheres to areas of inflammation, wrapping around inflammed organs, localising the infections & preventing serious diffuse peritonitis.

• It develops from caudal part of dorsal mesogastrium.

2. LESSER OMENTUM

• It extends from liver to stomach (lesser curvature) & duodenum (first 2cm).

• The part of lesser omentum from liver to stomach is called hepatogastric ligament, & part from liver to duodenum is called hepatoduodenal ligament.

• Hepatogastric ligament forms anterior free wall of lesser sac (omental bursa) & contains right & left gastric vessels, branches of gastric nerves & lymph vessels.

• Hepatoduodenal ligament forms right free margin, containing portal vein, hepatic artery proper, bile duct, lymphatics & hepatic plexus of nerves.

• Lesser omentum develops from ventral mesogastrium (dorsal part).

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