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Henry Gray (1825–1861). Anatomy of the Human Body. 1918.

pages 1151

fuse to form a small triangular fold connecting the right lobe of the liver to the diaphragm, and named the right triangular ligament of the liver. The apex of the triangular bare area corresponds with the point of meeting of the two layers of the coronary ligament, its base with the fossa for the inferior vena cava. (b) It covers the lower surface of the quadrate lobe, the under and lateral surfaces of the gall-bladder, and the under surface and posterior border of the left lobe; it is then reflected from the upper surface of the left lobe to the diaphragm as the inferior layer of the left triangular ligament, and from the porta of the liver and the fossa for the ductus venosus to the lesser curvature of the stomach and the first 2.5 cm. of the duodenum as the anterior layer of the hepatogastric and hepatoduodenal ligaments, which together constitute the lesser omentum. If this layer of the lesser omentum be followed to the right it will be found to turn around the hepatic artery, bile duct, and portal vein, and become continuous with the anterior wall of the omental bursa, forming a free folded edge of peritoneum. Traced downward, it covers the antero-superior surface of the stomach and the commencement of the duodenum, and is carried down into a large free fold, known as the gastrocolic ligament or greater omentum. Reaching the free margin of this fold, it is reflected upward to cover the under and posterior surfaces of the transverse colon, and thence to the posterior abdominal wall as the inferior layer of the transverse mesocolon. It reaches the abdominal wall at the head and anterior border of the pancreas, is then carried down over the lower part of the head and over the inferior surface of the pancreas on the superior mesenteric vessels, and thence to the small intestine as the anterior layer of the mesentery. It encircles the intestine, and subsequently may be traced, as the posterior layer of the mesentery, upward and backward to the abdominal wall. From this it sweeps down over the aorta into the pelvis, where it invests the sigmoid colon, its reduplication forming the sigmoid mesocolon.


FIG. 1035– Vertical disposition of the peritoneum. Main cavity, red; omental bursa, blue. (See enlarged image)