THE PERITONEUM. 



985 



greater sac. behind, a double fold, the lieno-renal ligament (lien, lienis, spleen) in 

 which run the splenic and pancreatic vessels. Anteriorly it forms with the 

 greater sac another double fold, the lieno-gastric ligament or g astro-splenic omen- 

 turn, in which pass the vasa brevia to the fundus of the stomach. This layer 

 then covers the posterior surface of the stomach and makes the posterior layer of 

 the lesser omentum, surrounding the three vessels and forming the anterior 

 boundary of the foramen of Winslow. Now it forms a part of the greater sac 

 and makes the anterior layer of the lesser omentum, covers the stomach ante- 

 riorly, dips down between it and the spleen to the anterior lip of the hilus to 

 meet the lesser sac, and so forms the gastro-splenic omentum. It then covers the 

 whole phrenic surface of the spleen, approaching the hilus from all sides, and 

 meeting the lesser sac again from behind. Completing the lieno-renal ligament, 

 it turns back on the left kidney to the abdominal wall and courses as parietal 

 peritoneum to the middle line again. 



If we trace a section through the level of the foramen of Winslow, the pan- 

 creas and liver are introduced (Fig. 610). 



Here again the peritoneum is traced from the mid-line anteriorly where it 

 invests the round ligament of the liver, then it covers the right abdominal wall 

 and posteriorly touches the diaphragm, passes anterior to the right kidney and 

 crosses the inferior vena cava, where it makes the posterior boundary of the 

 foramen of Winslow. It then extends to the left as the posterior wall of the 

 lesser sac. in front of the aorta, splenic vessels, pancreas and left kidney to the 

 hilus of the spleen. Xow the pancreas is interposed between this layer and 

 the left kidney, and the splenic vessels pass behind or just above the pancreas in 

 the lieno-renal ligament as before. The lesser sac makes a small blind pouch 

 near the hilus of the spleen, and its peritoneum covers the posterior wall of the 

 stomach, makes the posterior layer of the lesser omentum, bounds the foramen 

 of AA inslow anteriorly, and is then traced as in the last figure. 



The peritoneum simply surrounds this section of the liver, not showing any 

 coronary ligament. The peritoneal relations between stomach, kidnev, pancreas, 

 and spleen are shown m more detail in Fig. 611. 



Renal surface 

 Pouch of greater sac 



Lieno-renal ligament 

 Phrenic surface 

 Gastro-splenic omentum 

 Pouch of greater sac 



Gastric surf ace 



FIG. 611. -Horizontal section through the stomach, pancreas, spleen, and the left kidney to show peritoneal 

 reflections at hilus of spleen. Schematic. (G. S. H.) 



Here we see three pouches of peritoneum centering at the hilus of the spleen. 

 Anteriorly and posteriorly are two from the greater sac and in the centre is the 

 left blind extremity of the lesser sac. Should the structures at the hilus be 

 grasped, the hand would enclose anteriorly a layer of the greater sac, then two 

 of the lesser sac. then one of the greater, or four in all, and a section through 

 them would show their cut edges standing out as two concentric rings (Fig. 612). 



