3 i6 



ABDOMEN 



the superior mesenteric artery, at a lower level, is a part of 

 the aorta, and to the right of the aorta is the inferior vena cava. 

 Partly behind the duodenum and partly to the right of it, on a 

 posterior plane, is the lower pole of the right kidney. The 

 right ureter emerges from behind the duodenum and passes down- 

 wards on its way to the brim of the pelvis minor along the medial 

 border of the lower pole of the kidney, and then behind the ileo- 

 colic and the superior mesenteric arteries. The internal sper- 



Upper recess of 

 omental bursa 



Right flexure of 

 the colon (O.T. 

 hepatic flexure) 



Right subdivi- 

 sion of lower or 

 posterior perito- 

 neal compart- 

 ment 



Ascending colon 



Caecu 

 Vermiform 



Transverse colon 



Left flexure of 

 the colon (O.T. 

 splenic flexure) 



Left subdivision 

 of lower perito- 

 neal compart- 

 ment 



process 



"S2| 

 Ileum/^ 



FIG. 147. Abdomen after removal of Liver, Stomach, Jejunum and Ileum. 



matic vessels cross in front of the ureter (Fig. 146), and the 

 genito-femoral nerve passes downwards and laterally, behind 

 the ureter, on the anterior surface of the psoas major muscle. 

 Beyond the lateral border of the psoas major the fascia on the 

 anterior surface of the quadratus lumborum will be exposed. 



When the structures mentioned have been cleaned make an 

 incision through the lower layer of the transverse meso-colon, 

 from the upper end of the root of the mesentery to the transverse 

 colon ; then reflect the part of the lower layer of the transverse 

 meso-colon which lies to the right of the incision towards the 

 transverse colon. As the reflection proceeds the trunk and 

 branches of the middle colic artery and the accompanying veins, 



