Abdominal wall.pptVIP

Relationships of the stomach Anterior: Live (right part) Diaphragm (left upper part) Anterior abdominal wall (left lower part) Posterior－separated by peritonum of lesser sac from the following (“stumach-bed”) Pancreas Left suprarenal gland Left kidney Spleen Transverse colon and transvers mesoclon Arteries of stomach Left and right gastric arteries arise from celiac trunk and proper hepatic artery, repectively. These two vessels run in lesser omentum along lesser curvature , and anastomose end-to-end. Right and left gastroepiploic arteries arise from the gastroduodenal and splenic artery, repectively. These two vessels pass into the greater omentum, run parallel to the greater curvature, and anastomose end-to-end. Short gastric arteries, branches of splenic artery, course through the gastrosplenic ligament and supply the fundus of stomach. Posterior gastric artery (72%) arise from the splenic artery, course through the gastrophrenic ligament and supply the posterior wall of fundus of stomach. Venous drainage Right and left gastric veins empty directly into hepatic portal vein. Left gastroepiploic and short gastric veins drain into hepatic portal vein via the splenic vein. Right gastroepiploic vein join either superior mesenteric vein. Lymphatics of stomach Right and left gastric ln. lie along the same vessels and finally to the celiac ln. Right and left gastroomental ln. lie along the same vessels, the former drain into subpyloric ln., the latter drain into splinic ln. Supra- and subpyloric ln. receive lymphatics from pyloric part and finally to the celiac ln. Splenic ln. receive lymphatics from fundus and left third of stomach, and finally to the celiac ln. Nerve supply Parasympathetic innervation by anterior (left) and posterior (right) vagal trunks The anterior trunk divides into anterior gastric and hepatic branches The posterior trunk divides into posterior gastric and celiac branches The anterior and posterior gastric branches descend on the