280 



THE ABDOMEN AND PELVIS 



the duodenum. In certain cases, e.g. examination of the bile- 

 duct, it is necessary to explore the epiploic foramen. This can 

 be effected by passing the finger backwards and to the left along 

 the postero-lateral surface of the gall bladder till it reaches 

 the neck. The finger then slips behind the right margin of the 

 lesser omentum and enters the foramen. 



9 10 II 12 



FIG. 86. Transverse Section of Abdomen at the" level of the 

 Epiploic Foramen (of Winslow). 



1. Omental bursa (O.T. small sac). 



2. Omental tubercle of liver. 



3. Great sac. 



4. Stomach. 



5. Gastro - splenic ligament 



gastro-splenic omentum). 



6. Spleen. 



7. Lieno-renal ligament. 



8. Left kidney. 



9. Diaphragm. 



(O.T. 



10. Aorta. 



11. Inferior vena cava. 



12. Right kidney. [Winslow). 



13. Epiploic foramen (O.T. foramen of 



14. Liver. 



15. Gallbladder. 



16. Bile-duct. 



17. Portal vein. 



1 8. Hepatic artery. 

 19. Falciform ligament. 



The Omental Bursa (Lesser Sac) extends upwards between 

 the liver and the diaphragm to the upper end of the caudate 

 (Spigelian) lobe (Fig. 85). Below it rarely extends beyond the 

 transverse colon, owing to the fusion of the anterior and posterior 

 layers of the greater omentum. Its anterior wall is formed, 

 from above downwards, by (i) the liver, (2) the lesser omentum, 

 (3) the postero-inferior surface of the stomach, and (4) the two 

 anterior layers of the greater omentum. Its posterior wall is 

 formed, from below upwards, by (i) the transverse colon, (2) 



