1. بسم الله الرحمن الرحيم
Peritoneum

2. Objectives Define Peritoneum. Enumerate its functions.
Explain the general organization of the peritoneum.
Distinguish between Intraperitoneal and Retroperitoneal Structures.
Describe Peritoneal Ligaments.
Define lesser and greater omenta.
Understand the location of epiploic foramen.
Discuss mesentery and mesocolon.
Explain the Peritoneal sacs.

3. Peritoneum Is a double-layer serous membrane. 1.Parietal layer:
lines abdomino pelvic wall & folds
back on itself forming a double
Membrane: mesentery
Functions of mesentery:-
(1)Provides support:
Intestines: Mesentery & Mesocolon.
Stomach: Omenta.
Liver: Falciform ligament.
(2) Prevents intestinal twisting
(3) Stores fat
(4) Pathway for vessels & nerves
2. Visceral Layer:
covers the organs.
Peritoneal cavity:
Potential space containing a bit of
serous fluid.

4. The Peritoneum
The parietal peritoneum
The visceral peritoneum
The peritoneal cavity

5. The visceral
peritoneum
The peritoneal
cavity

6. Peritoneum in sagittal section

7. Peritoneum in transverse section

8. Peritoneal versus Retroperitoneal (transverse section)
Most of the internal organs are surrounded by visceral peritoneum: INTRAPERITONEAL Structures.
Some organs (e.g. kidneys) are between peritoneum on one surface, and the body wall on the other: RETROPERITONEAL Structures.

9. Peritoneal versus Retroperitoneal (sagittal section)

10. The retroperitoneal Structures
kidneys
suprarenal glands
ureters
duodenum
pancreas
aorta
inferior vena cava
nerves
ascending colon
descending colon

11. Peritoneal ligaments, Omenta & Mesenteries
Two layers fold of peritoneum that connect solid viscera to the abdominal walls, e.g. Falciform ligament, Triangular ligaments & Coronary ligaments of the liver.
Omenta:
Two layers fold of peritoneum that connect the stomach to another viscus, e.g. greater & lesser omenta.
Mesenteries:
Two layers fold of peritoneum connecting parts of the intestine to the posterior abdominal wall, e.g. mesentery of small intestine, transverse mesocolon, sigmoid mesocolon.

12. Peritoneal folds related to the stomach
The greater omentum:
Lies between the Stomach and the anterior abdominal wall.

13. Peritoneal folds related to the stomach
The lesser omentum
Passes from the lesser curvature of the stomach and first part of the duodenum to the inferior surface of the liver.

14. Greater omentum

15. Peritoneal folds related to the stomach and Kidney
The gastrosplenic (gastrolienal) ligament:
Passes from the greater
curvature of the stomach
to the spleen.
Splenorenal (lienorenal) ligament:
Connects the spleen to the posterior abdominal wall over the left kidney.

16. Peritoneal folds related to the Stomach
The gastrophrenic ligament :
Connects the superior part of the greater curvature
of the stomach to the diaphragm.

18. Peritoneal folds related to the Liver
The Falciform ligament: Passes from the parietal peritoneum on the anterior abdominal wall to the visceral peritoneum on the surface of the liver.
The round ligament of the liver (ligamentum teres hepatis):
Is the obliterated umbilical vein and it is found in the inferior free margin of the Falciform ligament.

19. Peritoneal folds related to the Liver
Coronary ligament:
Attaches the liver to the diaphragm. Two peritoneal ligaments are parts of the coronary ligament:
1. Left triangular ligament:
Is between the left lobe of
the liver and the diaphragm.
2. Right triangular ligament:
Is between the right lobe of

20. Mesentery of the small intestine
The mesentery suspends the jejunum and ileum from the posterior abdominal wall.

21. Mesoappendix: Attaches the appendix to the posterior abdominal wall and it contains the appendicular artery.

22. Peritoneal folds & ligaments of colon
Transverse mesocolon: Attaches the transverse colon to the posterior abdominal wall.
Phrenicocolic ligament: Attaches the left colic flexure to the diaphragm.
Sigmoid mesocolon: Suspends the sigmoid colon from the posterior abdominal wall.

24. Peritoneal sacs
Peritoneal structures all are found within a subdivision of the peritoneal cavity called the greater peritoneal sac. Posterior to the stomach and lesser omentum is a smaller subdivision of the peritoneal cavity called the lesser peritoneal sac (omental bursa).
The omental foramen (epiploic foramen, foramen of Winslow) connects the greater and lesser peritoneal sacs.

25. The Omental foramen Boundaries:
• Anterior: Hepatic portal vein, hepatic artery and bile duct contained within the lesser omentum.
• Posterior: Inferior vena cava & right crus of the diaphragm covered with parietal peritoneum.
• Superior: Caudate lobe of the liver covered with visceral peritoneum.
Inferior: First part of the duodenum covered with visceral peritoneum.

28. 2. Lesser and Greater Omenta

29. Lesser and Greater Omenta
hepatogastric ligament
Lesser
Omentum
hepatoduodenal ligament
the epiploic foramen
(of Winslow)

31. Greater Omentum

32. 3. The mesenteries

33. The mesenteries
Contents ?
mesentery of the
small intestine
transverse mesocolon
sigmoid mesocolon

34. Lesser Sac

35. The supra-colic compartment

36. Lt. anterior subphrenic space
Rt. anterior subphrenic space
Lt. anterior subphrenic space
Rt. posterior subphrenic
(Rt. Subhepatic)

37. left subhepatic
Space
(Lt. posterior subphrenic)
Morison’s pouch

38. Nerve supply to the peritoneum
The parietal peritoneum
phrenic nerve
intercostal
first lumbar nerves
obturator nerve
The visceral peritoneum
autonomic

39. Thank you 39 39