• The peritoneum (Greek

stretched over) is a large

serous membrane (serosa) lining
the abdominal cavity.
• It is divided into:
a. An outer or parietal layer
b. An inner or visceral layer
c. Folds of peritoneum by which
the viscera are suspended
Histology of Peritoneum

Histologically, composed
of:
•Outer fibrous layer-
provides strength
•Inner layer of
mesothelial cells-
secrete a serous fluid for
lubrication
Diagrammatic transverse section of the abdomen showing the
arrangement of the peritoneum
Parietal Peritoneum
• It lines the inner surface of
the abdominal and pelvic
walls and the lower
surface of the diaphragm.
• Can be easily stripped.
• Derived from somato-
layer
pleuric of plat
mesoderm.
lateral e
• Its blood supply and
supply
nerve are the same
as those of the
overlying body wall.
• Because of the somatic
innervation, parietal
peritoneum is pain
Visceral Peritoneum
• It lines the outer surface of
the
viscera. In fact it forms a part
and
parcel of the viscera.
• Cannot be stripped.
• Derived from splanchno-
pleuric
layer of lateral plate
mesoderm.
• Because of autonom
• Its
ic blood supply
innervation, and nerve
visceral
the
evokes pain when viscera
supply
peritoneum
is
are the same as those of
the underlying
stretched, viscera.
ischaemic or
distended.
Folds of Peritoneum
• Many organs withinthe abdomenare suspendedby folds
of peritoneum. Such organs are mobile.
• Other organs are fixed and immobile. Such organs are
said to be retroperitoneal.
• Some are partially covered.
• Few are sub-peritoneal (infra-peritoneal).
• Provide pathways for passage of vessels, nerves
and lymphatics.
Process of zygosis
Intraperitoneal Organs
(completely surrounded by peritoneum)

S= Stomach
A= Appendix
L= Liver
T=
Transverse
colon
D= Duodenum (1st part only)
S= Small intestines
P= Pancreas (tail only)
R= Rectum (upper 3rd only)
S= Sigmoid colon
S= Spleen
Retroperitoneal Organs
(covered by peritoneum on anterior
surfaces only)
S= Suprarenal glands
A= Aorta/Inferior Vena Cava
D= Duodenum (except for 1st part)
P= Pancreas (head and neck)
U= Ureters
C= Colon (ascending and descending
parts) K= Kidneys
E= Esophagus
R= Rectum
e
• Provide passage for nerves, vessels
& lymphatics
CLINICAL ANATOMY
• Ascites: Collection of free fluid in the peritoneal cavity is known as
ascites. Common causes of ascites are cirrhosis of the liver,
tubercular peritonitis, congestive heart failure, and malignant
infiltration of the peritoneum. Veins also get prominent in cirrhosis
of liver.
• Peritonitis
• Pneumoperitoneum
• Laparoscopy
• Laparotomy
• Greater omentum limits the spread of infection by sealing off the
site of ruptured vermiform appendix or gastric ulcer and tries to
delay the onset of peritonitis. It is called ‘‘abdominal policeman’’.
• Peritoneal dialysis
Paracentesis

X sites for
paracentesis
Peritoneal Folds
Derivatives of the different parts of gut
V

R
 https://www.memorangapp.com/flashcards/84729/Abdominal+Wall+and+Peritoneal+Sac+(Lecture+%231

• Cranial most part forms the

gastrophrenic ligament

https://anatomyqa.com/stomach-anatomy/
Greater Omentum
• The greater omentum (Latin apron) is a large fold of peritoneum which hangs
down from the greater curvature of the stomach like an apron and covers the
loops of intestines to a varying extent.
• Made up of 4 layers.

Contents
• Right and left gastroepiploic vessels
• Fat
Functions
1. It is a storehouse of fat
2. It protects the peritoneal cavity against
infection (collection of macrophages
form milky spots)
3. Also known as “policeman of the
abdomen”

https://m.youtube.com/watch?v=_bGjvdc5Sq
Attachments
LESSER OMENTUM
This is a fold of peritoneum which extends from the lesser curvature of the
stomach and the first 2 cm of the duodenum to the liver. The portion of the lesser
omentum between the stomach and the liver is called the hepatogastric ligament,
and the portion between the duodenum and the liver is called the
hepatoduodenal ligament.

Attachments:
Inferiorly: lesser curvature of stomach and duodenum
Superiorly: liver in the form of an inverted ‘L’
Contents:
The right free margin of the lesser omentum contains:
1. The proper hepatic artery
2. The portal vein
3. The bile duct
4. Lymph nodes & lymphatics
5. Hepatic plexus of nerves
The attachments and contents of the lesser omentum. The liver has
been
turned upwards so that its posteroinferior surface can be seen
MESENTERY
The mesentery (Greek fold of intestine) of the small
intestine or mesentery proper is a broad, fan-shaped
fold of peritoneum which suspends the coils of jejunum
and ileum from the posterior abdominal wall.
 Border
•s The attached border, or root of the
mesentery, is 15 cm long, it crosses
the following structures:
1.The third part of the
duodenum where the
superior mesenteric
vessels enter into it
2.The abdominal aorta
3.The inferior vena cava
4.The right ureter
5.The right psoas major
• Free or intestinal border is
6 metres long.
• The breadth of the mesentery is
maximum and is about 20 cm in the
central part, but gradually
Contents
1. Jejunal and ileal branches of the superior
mesenteric
artery
2. Accompanying veins
3. Autonomic nerve plexuses
4. Lymphatics or lacteals
5. 100–200 lymph nodes
6. Connective tissue with fat
Mesoappendix
It is a small, triangular fold of peritoneum which
suspends the vermiform appendix from the
posterior surface of the lower end of the
mesentery close to the ileocaecal junction.
Transverse Mesocolon
Attachments
• The root of the transverse
mesocolon is attached to the
anterior surface of the head,
and the anterior border of the
body of the pancreas.
Contents
• It contains the middle colic
vessels; the nerves, lymph
nodes and lymphatics of the
transverse colon.
 Sigmoid Mesocolon

Features
• This is a triangular (Greek ‘S’
shape) fold of peritoneum which
suspends the sigmoid colon
from the pelvic wall.

Attachments
• The root is shaped like an
inverted ‘V’.

Contents
• The sigmoid vessels in the left
limb;
superior rectal vessels, nerves,
lymph nodes and lymphatics in
the right limb of the sigmoid
colon.