1012 



THE ORGANS OF DIGESTION. 



rior curve of the duodenum can be seen attached to the liver by a ligament in 

 which can be felt three cords, the lig. hepato-duodenale, and to the gall-bladder 

 by a simple fold, the lig. cystico-duodenale. 



Now pull toward the left this superior curve of the duodenum, and a deep 

 space is formed bounded above by the right lobe of the liver. Below this is the 

 right kidney, and to the left a series of organs all bound together by the same 

 layer of peritoneum. The peritoneum covering the anterior surface of the right 

 kidney passes from right to left, above, upon the vena cava inferior, thence behind 

 an orifice, foramen of Winslow, into a large cavity which cannot be seen, the 

 atrium bursce omentalis (Fig. 635). As this layer covers the vena cava it passes 

 to the posterior surface of the liver, and is the lig. hepato-renale. A little lower 

 than this, where the vein is covered by the superior angle of the duodenum, the 

 peritoneum from the kidney covers the right and anterior surface of the first por- 

 tion and part of the surface of the descending portion, running below into the 



Diaphragm 



Lat. lig. of liver 



Recessus hepatico- 



renalis 



Lig. hepatico-renale 

 Diaphragm 



Vena cava 

 Foramen of Winslow 



Lig. duodeno-renal 



Ligamentnm teres 



Liy. hepatico-duod. 

 Posterior layer of 

 lesser amentum. 

 'Hepatic artery 



Lig 



hepatico-colicum 



Common bile-duct ' Vena P orta 



FIG. 636. Peritoneal relations of the liver, first portion of duodenum, and entrance to the lesser sac. 

 (Luschka). 



gastro-colic part of the great omentum. Often the renal peritoneum passing to 

 the first part of duodenum is raised into a fold, from the summit of the kidney to 

 the summit of the curve of the duodenum, called lig. duodeno-renole (Huschke). 

 Finally, still lower, where the hepatic flexure of the colon crosses about the mid- 

 dle of the descending duodenum, the renal peritoneum passes directly over the 

 hepatic flexure of colon and fixes it. Three organs are thus bound together by a 

 continuous layer, hepatic flexure of colon, duodenum, and right kidney. In other 

 cases the hepatic flexure and ascending colon present a mesentery ; here the renal 

 peritoneum loses itself on the right leaf of this mesentery, which now covers in 

 the descending duodenum. To see another side of the descending duodenum, 

 incise the two anterior layers of the great omentum along the inner side of the 

 duodenum and upper side of the transverse colon. This will open the bursa 

 omentalis (Fig. 616). The large peritoneal surface which forms the posterior 

 wall of this sac covers the pancreas and the left side of the descending duodenum. 

 The rest of the duodenum still remains concealed under thick coverings. To see 



