Anatomic Features

The peritoneal cavity is subdivided by peritoneal reflections and mesenteric attachments into several compartments and recesses (Fig. 4-105a). These are anatomically continuous, either directly or indirectly.

The major barrier dividing the abdominal cavity is the transverse mesocolon. Below this, the obliquely oriented small bowel mesentery divides the inframesocolic space into two compartments of unequal sizeā€”the right and left infracolic spaces. Its main axis, nevertheless, is directed toward the right lower quadrant in relation to the terminal ileum and cecum. The right infracolic space terminates at their junction. The left infracolic space is open anatomically to the pelvis to the right of the mid-line; toward the left, it is restricted from continuity with the pelvic cavity by the sigmoid mesocolon.

The right and left paracolic gutters are lateral to the attachments of the peritoneal reflections of the ascending and descending colon. They represent potential communications between the lower abdomen and pelvis below with the supramesocolic area above. On the left, however, the phrenicocolic ligament48 partially separates the paracolic gutter from the perisplenic (left subphrenic) space. This ligament extends from the splenic flexure of the colon to the diaphragm at the level of the 11th rib.

The pelvis is the most dependent portion of the peritoneal cavity in either the supine or erect position. Its compartments include the midline cul-de-sac or pouch of Douglas (rectovaginal pouch in the female and rec-tovesical pouch in the male) and the lateral paravesical recesses.

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Essentials of Human Physiology

Essentials of Human Physiology

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