INFLECTIONS OF THE PERITONEUM. 827 



If the examination of the folds of the peritoneum be commenced on the 

 under surface of the diaphragm, it will be found that on the left side it can 

 be traced back to the posterior wall of the abdomen, and down in front of the 

 upper part of the kidney to the commencement of the descending colon. 

 Further to the right, it is reflected from the diaphragm over the front of 

 the stomach, and from the left of the stomach passes across a very short 

 interval to the spleen, which it completely invests ; and it is continued back 

 from the spleen to the abdominal wall. Still further to the right, the 

 peritoneum is reflected from the diaphragm to the liver, invests the whole 

 superior surface of that organ, and passes round its anterior and lateral 

 margins to invest the whole of its inferior surface, with the exception only 

 of so much as lies behind the portal fissure, viz., the lobule of Spigelius. 

 On the upper surface of the liver the peritoneum is thrown into a right and 

 a left fossa by a vertical antero-posterior fold attaching it to the diaphragm, 

 which is named the falciform, or suspensory ligament of the liver. In the 

 lower margin of this ligament a fibrous cord, consisting of the obliterated 

 remains of the umbilical vein, and named the round ligament of the liver, 

 extends upwards from the umbilicus to the longitudinal fissure which divides 

 inferiorly the right lobe of the liver from the left ; and it is the reflection of 

 the peritoneum from this cord which forms the falciform ligament. The 

 thick posterior border of the liver, uninvested with peritoneum, is in contact 

 with the diaphragm ; and the reflexions of peritoneum from the upper and 

 under surfaces of the organ to the parietes above and below this border con- 

 stitute the coronary ligament. Towards the right and left extremities of 

 the liver the superior and inferior layers of the coronary ligament come into 

 contact for a little way, and form the right and left triangular ligaments of 

 the liver. 



The portion of peritoneum reflected from the under surface of the liver, , 

 opposite the portal fissure, passes down over the vena portse, hepatic artery, 

 and biliary ducts, to the pyloric extremity of the stomach and first part of 

 the duodenum ; while that which invests the part of the liver to the right 

 of the portal fissure is conducted back to the posterior wall of the abdomen. 

 If now, the disposition of the peritoneum be examined in the spot where 

 those two modes of arrangement meet, an aperture sufficiently large to 

 admit a finger, and furmed by invagination of the peritoneum, will be found 

 leading, from right to left, behind the hepatic vessels and duct : this aper- 

 ture is the foramen of Winslow ; and the fold of peritoneum in front of it, 

 containing the portal vein, hepatic artery, and biliary ducts, is termed the 

 small or gastro-hepatic omentum. The foramen of Winnlow has above it a 

 portion of the liver ; behind it the vena cava inferior ; below it the duodenum ; 

 and in front the small omentum. The invagination of peritoneum which 

 takes place at the foramen of Winslow is of great extent, expanding to form 

 a large pouch, which lies behind the stomach, and stretches downwards to a 

 variable degree in front of the transverse colon. This is the sac of the 

 omentum or smaller cavity of the peritoneum, which will be presently 

 described. 



On tracing downwards the peritoneum investing the anterior surface of 

 the stomach, it is seen to be prolonged from the inferior border of that 

 viscus to form a pendulous fold of omentum lying loosely in front of the 

 colon and small intestines, and having a free margin iuferiorly. Folding 

 backwards on itself at this margin, the peritoneum passes upwards to the 

 transverse colon and becomes adherent to its surface, whence it is continued 

 back to the abdominal wall. 



