ABDOMINAL CAVITY 439 



pyloric end of the stomach, first backwards to the neck of 

 the gall-bladder, then downwards behind the transverse colon 

 and meso-colon, to the right of the median plane, and finally 

 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 small intestine. 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 ctzcum (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, the right colic 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 

 downwards and forwards. It is connected to the stomach 

 by the great 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 wall be found to terminate, immediately 

 below the lower extremity of the spleen, by joining the 

 descending colon at a second angular bend, the left colic 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 true pelvis, 

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

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

 be found that the pelvic colon either 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 



