AN47.1-14 | Abdominal cavity — Glossary

Continuous serous membrane (~2 m2) with a parietal layer (lining the abdominal wall) and a visceral layer (covering organs); the potential space between them is the peritoneal cavity

Four-layered peritoneal fold hanging from the greater curvature of the stomach; the 'policeman of the abdomen' that wraps around inflamed structures to wall off infection

Peritoneal fold from the liver to the lesser curvature of the stomach and D1 duodenum; the hepatoduodenal ligament portion contains the portal triad

Communication between the greater and lesser sacs (foramen of Winslow); bounded by the hepatoduodenal ligament anteriorly and the IVC posteriorly

Hepatorenal recess; the most dependent part of the peritoneal cavity in the supine position; where free fluid first collects on FAST ultrasound in trauma

Rectouterine pouch in females; most dependent part of the peritoneal cavity in the upright position; aspirated via posterior fornix for fluid/blood/pus

Formed behind the neck of the pancreas by the union of the SMV and splenic vein; carries nutrient-rich blood from the gut to the liver; normal pressure 5-10 mmHg

Elevated portal venous pressure (HVPG >12 mmHg); causes oesophageal varices, caput medusae, splenomegaly, ascites; most commonly from cirrhosis

Pattern of dilated veins radiating from the umbilicus in portal hypertension; flow is away from the umbilicus to both SVC and IVC territories

Dilated submucosal veins at the lower oesophagus from portosystemic anastomosis; rupture causes life-threatening haematemesis

Triangle bounded by the cystic duct, common hepatic duct, and inferior liver surface; contains the cystic artery; the critical surgical landmark during cholecystectomy

First unpaired branch of the abdominal aorta at T12; supplies the foregut via left gastric, common hepatic, and splenic arteries

Second unpaired branch at L1; supplies the midgut from the duodenum (distal to the ampulla) to the proximal two-thirds of the transverse colon

Third unpaired branch at L3; supplies the hindgut from the distal transverse colon to the upper rectum

Autonomic plexus surrounding the coeliac trunk at T12-L1; receiving splanchnic and vagal fibres; coeliac plexus block used for pancreatic cancer pain

Motor and sensory nerve to the diaphragm from C3,C4,C5; central diaphragmatic irritation is referred to the shoulder tip via the C4 dermatome

Left shoulder tip pain from diaphragmatic irritation by blood following splenic rupture; referred via the phrenic nerve C4 dermatome

Primary muscle of respiration; dome-shaped musculotendinous partition between the thorax and abdomen; three openings at T8, T10, and T12

Congenital posterolateral diaphragmatic hernia (90% left-sided) causing pulmonary hypoplasia; presents at birth with respiratory distress and scaphoid abdomen

Herniation of abdominal contents through the oesophageal hiatus; sliding type (90%, associated with GORD) or paraesophageal (risk of strangulation)

Branch of the ileocolic artery (from SMA); an end artery — thrombosis causes appendiceal gangrene and perforation

Suspensory muscle of the duodenum at the DJ flexure (L2); landmark dividing upper from lower GI tract; upper GI bleeding = above, lower = below