(lecture 3) - kgmu.org
Transcript of (lecture 3) - kgmu.org
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(lecture 3)
29.04.2020
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SPECIAL REGIONS OF THE PERITONEAL CAVITY
• Parts of peritoneal cavity: Abdomen proper and Pelvic cavity
• Abdominal cavity is divided into: Supracolic and Infracolic compartments
• Subdivisions of supracolic compartment: Number of subphrenic spaces
• Subdivisions of infracolic compartment: Right and left parts
• Paracolic gutters: Right and left
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https://teachmeanatomy.info/abdomen/areas/peritoneal-cavity/
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Supracolic Compartment/Subphrenic Spaces
Classification
The intraperitoneal spaces are:1. The left anterior space (left subphrenic space)
2. The left posterior space (left subhepatic or lesser sac)
3. The right anterior space (right subphrenic space)
4. The right posterior space (right subhepatic or Morrison’s pouch)
The extraperitoneal spaces are:1. The right extraperitoneal space
2. The left extraperitoneal space
3. Midline extraperitoneal space (bare area of liver)
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(a) Subphrenic spaces and (b) subphrenic spaces shown in
relation to the transverse colon
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https://www.slideshare.net/JaPatel1/peritoneum-and-peritoneal-cavity-90232486
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Hepatorenal Pouch (Morrison’s Pouch)Boundaries:
Anteriorly
• The inferior surface of the right lobe of
the liver.
• The gallbladder.
Posteriorly
• The right suprarenal gland
• The upper part of the right kidney
• The second part of the duodenum
• The hepatic flexure of the colon
• The transverse mesocolon
• A part of the head of the pancreas
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• Superiorly: The inferior layer of
the coronary ligament
• Inferiorly: It opens into the
general peritoneal cavity
• Left: Communicate with omental
bursa
• Right: Limited by diaphragm
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Infracolic Compartments
• Right Infracolic Compartment
• Left Infracolic Compartment
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Paracolic gutters
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Rectouterine Pouch (Pouch of Douglas)
Boundaries:
• Anteriorly: uterus and
posterior fornix of vagina
• Posteriorly: rectum
• Inferiorly (floor):
rectovaginal fold of
peritoneum
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Morrison’s or hepatorenal pouch with rectouterine or Douglas pouch
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Sites of intraperitoneal subphrenic & subhepatic abscesses
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Peritoneal Fossae (Recesses)
• Small pockets of peritoneal cavity enclosed by small,
inconstant folds of peritoneum.
• Commonly occur at transitional zones between the
absorbed and unabsorbed parts of mesentery.
• Best observed in fetuses, mostly obliterated in adults.
• Sometimes they persist to form potential sites for
internal hernia and strangulation.
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Classification
• Lesser Sac
• Duodenal Fossae or Recesses
• Caecal Fossae
• Intersigmoid Recess
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LESSER SAC OR OMENTAL BURSA
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Duodenal Fossae or Recesses
• The superior duodenal recess
• The inferior duodenal recess
• The paraduodenal recess
• The retroduodenal recess
• The duodenojejunal or mesocolic recess
• The mesentericoparietal fossa of Waldeyer
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Caecal Fossae
• The superior ileocaecal recess
• The inferior ileocaecal recess
• The retrocaecal recess
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The Intersigmoid Recess
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CLINICAL ANATOMY• Internal hernia: May occur in the opening of
lesser sac. It may also occur in between
paraduodenal recesses. One has to remember the
inferior mesenteric vein in the paraduodenal fold
during reduction of the hernia.
• Pain of foregut derived structures is felt in the
epigastric area.
• Pain of midgut derived structures is felt in the
periumbilical area.
• Pain of hindgut derived structures is felt in the
suprapubic area.
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Referred pain from the gut-derived structures
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THANKYOU