270 ABDOMEN 



the fundus it runs forwards and downwards with a marked 

 convexity to the left ; finally it runs to the right and slightly 

 backwards with a convexity downwards. The second portion 

 is frequently spoken of as the left lateral border and the last 

 portion as the inferior border of the stomach ; the junction of 

 these two parts is commonly the lowest portion of the organ 

 and, when the body is recumbent, it lies on a level with the 

 tips of the tenth costal cartilages, but in the erect posture, 

 and when the stomach is full it may descend to a much 

 lower point, even to the level of the umbilicus or still 

 lower. The dissector will find that the lesser curvature 

 is attached to the lower and posterior surfaces of the liver 

 by a fold of peritoneum which is called the lesser omentum. 

 The part of the greater curvature immediately adjacent 

 to the oesophagus is attached to the diaphragm by a peri- 

 toneal fold, the gastro- phrenic ligament ; the descending part 

 of the greater curvature is attached to the spleen by the gastro- 

 splenic ligament (O.T. gastro-splenic omentum) ; and the lower 

 part of the greater curvature is connected with the transverse 

 colon by the greater omentum. The first of these connections 

 can be demonstrated by pulling the stomach downwards, the 

 second, by pulling it to the right, and the last, by raising 

 the greater omentum, which hangs down from the lower 

 border, and turning it upwards over the lower margin of 

 the costal arch. The surfaces of the stomach are an anterior 

 or superior and a posterior or inferior. The latter cannot 

 be seen at the present stage of dissection; it rests on the 

 stomach bed. The anterior is directed upwards and forwards ; 

 and the student should note that it is in relation to the 

 left and above with the diaphragm, below with the anterior 

 wall of the abdomen, in the region of the subcostal angle, 

 and above and to the right with the lower surface of the 

 liver. 



The above account gives an indication of the general 

 form, position, and relations of the stomach which are met 

 with after death when the body is lying upon its back, but the 

 student must realise that whilst the connections of the stomach 

 are always the same, its size, form, and position vary with the 

 amount of its contents, the stage of digestion, and the position 

 of the body. A glance at Figs. 122, 123, 124, 125, which 

 represent drawings of radiographs of stomachs in different 

 conditions of distension, digestion, and position of the body, 



