1156 SPLANCHNOLOGY 



the posterior layer of the gastrosplenic ligament. It covers the postero-inferior 

 surfaces of the stomach and commencement of the duodenum, and extends 

 upward to the liver as the posterior layer of the lesser omentum; the right margin 

 of this layer is continuous around the hepatic artery, bile duct, and portal vein, 

 with the wall of the general cavity. 



The epiploic foramen (foramen epiploicum; foramen of Winslow) is the passage of 

 communication between the general cavity and the omental bursa. It is bounded 

 in front by the free border of the lesser omentum, with the common bile duct, 

 hepatic artery, and portal vein between its two layers; behind by the peritoneum 

 covering the inferior vena cava; above by the peritoneum on the caudate process 

 of the liver, and below by the peritoneum covering the commencement of the 

 duodenum and the hepatic artery, the latter passing forward below the foramen 

 before ascending between the two layers of the lesser omentum. 



The boundaries of the omental bursa will now be evident. It is bounded in front, 

 from above downward, by the caudate lobe of the liver, the lesser omentum, the 

 stomach, and the anterior two layers of the greater omentum. Behind, it is limited, 

 from below upward, by the two posterior layers of the greater omentum, the trans- 

 verse colon, and the ascending layer of the transverse mesocolon, the upper surface 

 of the pancreas, the left suprarenal gland, and the upper end of the left kidney. 

 To the right of the esophageal opening of the stomach it is formed by that part 

 of the diaphragm which supports the caudate lobe of the liver. Laterally, the 

 bursa extends from the epiploic foramen to the spleen, where it is limited by 

 the phrenicolienal and gastrolienal ligaments. 



The omental bursa, therefore, consists of a series of pouches or recesses to which 

 the following terms are applied: (1) the vestibule, a narrow channel continued 

 from the epiploic foramen, over the head of the pancreas to the gastropancreatic 

 fold; this fold extends from the omental tuberosity of the pancreas to the right 

 side of the fundus of the stomach, and contains the left gastric artery and coronary 

 vein; (2) the superior omental recess, betw r een the caudate lobe of the liver and the 

 diaphragm; (3) the lienal recess, between the spleen and the stomach; (4) the 

 inferior omental recess, which comprises the remainder of the bursa. 



In the fetus the bursa reaches as low as the free margin of the greater omentum, 

 but in the adult its vertical extent is usually more limited owing to adhesions 

 between the layers of the omentum. During a considerable part of fetal life the 

 transverse colon is suspended from the posterior abdominal wall by a mesentery 

 of its own, the two posterior layers of the greater omentum passing at this stage 

 in front of the colon. This condition occasionally persists throughout life, but as 

 a rule adhesion occurs between the mesentery of the transverse colon and the pos- 

 terior layer of the greater omentum, with the result that the colon appears to receive 

 its peritoneal covering by the splitting of the two posterior layers of the latter fold. 

 In the adult the omental bursa intervenes between the stomach and the structures 

 on which that viscus lies, and performs therefore the functions of a serous bursa 

 for the stomach. 



Numerous peritoneal folds extend between the various organs or connect them 

 to the parietes; they serve to hold the viscera in position, and, at the same time, 

 enclose the vessels and nerves proceeding to them. They are grouped under the 

 three headings of ligaments, omenta, and mesenteries. 



The ligaments will be described with their respective organs. 



There are two omenta, the lesser and the greater. 



The lesser omentum (omentum minus; small omentum; gastrohepatic omentum} is the 

 duplicature which extends to the liver from the lesser curvature of the stomach and 

 the commencement of the duodenum. It is extremely thin, and is continuous with the 

 two layers of peritoneum which cover respectively the antero-superior and postero- 

 inferior surfaces of the stomach and first part of the duodenum. When these 

 two layers reach the lesser curvature of the stomach and the upper border of the 



