AN47.1-14 | Abdominal cavity — Summary & Reflection

REFLECT

KEY TAKEAWAYS

Module Summary — Abdominal Cavity

Peritoneum: Greater sac + lesser sac (communicates via epiploic foramen of Winslow). Hepatorenal pouch (Morrison) and pouch of Douglas are dependent recesses. Greater omentum = "policeman" walls off infection. Ascites: cirrhosis, malignancy, TB. Subphrenic abscess: right subphrenic most common; referred shoulder pain via phrenic nerve.

Viscera: Stomach blood from coeliac trunk; vagotomy types. Duodenum: ampulla of Vater at 2nd part; SMA syndrome at 3rd part. Liver: dual blood supply; portal triad at porta hepatis. Calot's triangle: cystic duct + CHD + liver = cystic artery inside (critical in cholecystectomy). Appendix: blood from ileocolic (end artery). Pancreas neck over portal vein.

Vessels: Portal vein = SMV + splenic vein (behind neck of pancreas). Coeliac trunk at T12, SMA at L1, IMA at L3, aortic bifurcation at L4. Right renal artery crosses behind IVC.

Portosystemic anastomoses: (1) Oesophagus (varices/haematemesis); (2) Umbilicus (caput medusae); (3) Anorectal (rectal varices); (4) Retroperitoneum; (5) Diaphragm.

Nerve plexuses: Coeliac plexus (T5–T12 sympathetics + vagus) at coeliac trunk. Superior hypogastric plexus (at L5/aortic bifurcation) — injury in colorectal surgery causes ejaculatory dysfunction.

Diaphragm: T8 = IVC; T10 = oesophagus + vagus; T12 = aorta + thoracic duct + azygos. Motor + central sensory = phrenic (C3,4,5). Referred shoulder pain from phrenic irritation. Bochdalek hernia (posterolateral, left) = neonatal emergency. Hiatus hernia (sliding = GORD; rolling = volvulus risk).