ABDOMINAL CAVITY 275 



and finally the third or inferior part from right to left, 

 behind the upper part of the mesentery, to the duodeno- 

 jejunal flexure, where it becomes continuous with the jejunum. 

 He will thus demonstrate the continuity of the three portions 

 of the duodenum. 



Next he should follow the mesentery downwards into the 

 right iliac fossa, where he will find that the terminal portion 

 of the ileum joins the large intestine a short distance above 

 the lower end of the latter and on its left side. The portion 

 of the large intestine below the entrance of the ileum is a 

 sac which terminates blindly below and is called the cacum 

 (intestinum cacum). Turn the caecum and the lowest part of 

 the ileum upwards and to the right to expose the vermiform 

 process, which springs from the medial and posterior aspect 

 of the caecum a short distance below the ileo-caecal junction. 

 The caecum is continuous above with the ascending colon, 

 which must be traced upwards to the right hypochondriac 

 region where, under cover of the anterior part of the lower 

 surface of the liver, it joins the transverse colon at an 

 angular bend, called the right flexure of the colon (O.T. 

 hepatic flexure}. The transverse colon extends across the 

 abdomen from the right to the left hypochondriac region, 

 forming a bold curve with the convexity directed down- 

 wards and forwards. It is connected to the stomach 

 by the greater omentum and to the posterior wall of the 

 abdomen by the transverse meso-colon. It is exposed when 

 the omentum is turned upwards over the lower part of the 

 costal arch and it will be found to terminate, immediately 

 below the inferior extremity of the spleen, by joining the 

 descending colon at a second angular bend, called the left flexure 

 of the colon (O.T. splenic flexure}. The descending colon 

 passes downwards through the left lumbar region, and, at the 

 level of the iliac crest, it becomes the iliac colon, which runs 

 downwards and medially across the left iliac region, parallel 

 with the inguinal ligament, to the brim of the pelvis minor, 

 where it becomes the pelvic colon. To expose the pelvic colon 

 lift the coils of small intestine out of the pelvis minor. It will 

 then be found either that the pelvic colon runs first across to 

 the right side of the pelvis, above the bladder, then back to 

 the left side, and finally downwards and medially to the third 

 piece of the sacrum, where it becomes continuous with the 

 rectum ; or that the first loop, instead of lying on the upper 



