SURGICAL ANATOMY OF THE ABDOMEN 15 



anterior border is in contact with duodenum and the 

 the lesser curvature of the stomach. 



The Kidneys. — The right has its anterior border 

 reaching as far forward as the sixteenth rib, where it is 

 in apposition with the liver ; its posterior extends back 

 to the first lumbar vertebra, its inferior edge as low as 

 the middle third of the last rib but one. To the posterior 

 part of this gland the base of the caecum is attached. 

 The renal artery penetrates the organ immediately under 

 the last rib. The left kidney has its anterior border 

 reaching only as far forward as the last rib, its posterior 

 to the transverse process of the third lumbar vertebra. It 

 lies up much closer to the spine than its fellow on the 

 opposite side. 



A knowledge of the situation and position of the various 

 abdominal organs is essentially necessary to the surgeon, 

 for he may at any time be called upon to perform opera- 

 tions in their vicinity. Take, for example, the simple 

 one of ' puncturing the bowels,' in performing which, by 

 entering the trocar too high up on the right side, the 

 duodenum or right kidney may be wounded, or the left 

 side of the spleen or the left kidney. Such serious com- 

 plications, liable to arise out of even a simple operation, 

 can only be averted by a clear and certain acquaintance 

 with the anatomy of the viscera. It is particularly 

 important to know the position they occupy in the living 

 body ; having to this end arbitrarily divided the abdomen 

 into the various regions before noticed, we will conclude 

 this chapter by stating, in tabular form, the contents of 

 each. 



Right Side of Abdomen. 



{Anterior border of right kidney, 

 prerenal capsule, and supero- 

 posterior part of right lobe of 

 liver. 



