THE KIDNEYS. 



1263 



commencement of the transverse colon. The part of the kidney related to the 

 duodenum lies to the medial side of the area which touches the colon, but the exact 

 amount of the kidney in 'contact with each of these two parts of intestine varies 

 much in different subjects. Frequently the colon and the kidney are both covered 

 by peritoneum where they are in contact, but the duodenum is bound down to the 

 kidney by connective tissue. In addition to the structures mentioned, some portion 

 of the ileum, or of the jejunum, is often found in contact with a small part of the 

 right kidney near its inferior end. 



In some cases the peritoneal membrane does not cover the whole of the surface 

 in contact with the liver, and then the superior part of the hepatic area of the 

 kidney is, like the anterior aspect of the suprarenal gland, bound by connective 

 tissue to the " uncovered " area on the posterior aspect of the liver. 



Suprarenal area 



Suprarenal area 



Gastric area 



plenic area 



itic area 



lodenal area 



Colic area 



sta iliaca 



rista iliaca 



FIG. 984. ANTERIOR ASPECT OF THE KIDNEYS AND GREAT VESSELS. The drawing' was made, before 

 removal of the organs, from a specimen in which the viscera had been hardened in situ. The dotted lines 

 mark out the areas which were in contact with the various other abdominal viscera. 



Left Kidney. The extreme superior and medial part of the anterior aspect of 

 the left kidney is united by connective tissue to the lower part of the left supra- 

 renal gland, and the area immediately below this is in contact with the stomach 

 and the pancreas. The pancreas, like the suprarenal gland, is bound down to the 

 kidney by connective tissue, but the stomach is separated from the area with which 

 it is in apposition by a portion of the omental bursa. The area in actual contact 

 : with the stomach is a small somewhat triangular district situated above the level 

 at which the pancreas is related to the kidney. The superior and lateral part of the 

 . anterior aspect of the kidney is related to the spleen, the two organs being separated 

 by a portion of the general peritoneal cavity, except along the area where spleen 

 and kidney are connected by the lieno-renal ligament. The anterior surface of 

 i the inferior end of the left kidney is related, towards the medial side, to a part of 

 1 the jejunum, and, towards the lateral side, to the left flexure of the colon or to a 

 i part of the descending portion of the colon. In most cases, however, the colon 

 * lies against the posterior abdominal wall to the lateral side rather than on the 

 i anterior surface of the left kidney. 



