WHAT YOU WERE AFRAID TO ASK ABOUT THE SURGICAL ANATOMY OF THE PERITONEUM:
- What is the Omental Bursa?
- What are the margins of the omental foramen [of Winslow]? Does it have any function?
- It is located behind the omentum minor and the stomach, below the liver and above the transverse mesocolon.
TO ANSWER THE QUESTIONS
What is the Omental Bursa?
- The omental bursa or bursa omentalis is a diverticulum of the peritoneal cavity, also known as the Lesser sac. It is formed because the midgut rotates 90 degrees counterclockwise during embryological development.
- It is located behind the omentum minor and the stomach, below the liver and above the transverse mesocolon.
How is the omental foramen [of Winslow] formed? Does it have any function?
- The boundaries of the omental foramen of Winslow are:
- Anterior: hepatic pedicle (hepatoduodenal ligament)
- Posterior: inferior vena cava (covered by the posterior parietal peritoneum)
- Superior: the caudate lobe [of Spiegel] of the liver.
- Inferior: duodenal bulb (1st portion)
- The omental foramen is important because it is a decline zone in prone position: all the fluids that could be secreted in the peritoneal cavity could go to this zone. Also, because it is a natural orifice, internal hernias can occur at this point.
The peritoneum has different forms: omentum, mesentery, ligaments and coalescence fasciae. Are they different or the same?
- The omentum is a peritoneal formation that has 2 layers with a neurovascular component that connects 2 nearby organs.
- A meso is a peritoneal formation that connects the abdominal wall to an organ and has a neurovascular component.
- A ligament is a peritoneal formation that connects 2 organs or the abdominal wall to an organ, and has no neurovascular component.
- A coalescence fascia is a layer that its formed because 2 layers of peritoneum are in proximity for a long time. It is an avascular plane.
