Phrenicocolic ligament

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Phrenicocolic ligament
Gray1040.png
Diagram to show the lines along which the peritoneum leaves the wall of the abdomen to invest the viscera. (Phrenicocolic ligament labeled at center right.)
Details
Identifiers
Latin ligamentum phrenicocolicum
TA98 A10.1.02.211
TA2 3769
FMA 16551
Anatomical terminology

A fold of peritoneum, the phrenicocolic ligament is continued from the left colic flexure to the thoracic diaphragm opposite the tenth and eleventh ribs; it passes below and serves to support the spleen, and therefore has received the name of sustentaculum lienis. [1]

Contents

Friedrich Wilhelm Hensing Friedrich Wilhelm Hensing (1719-1745).jpg
Friedrich Wilhelm Hensing

The phrenicocolic ligament is also called Hensing's ligament after Friedrich Wilhelm Hensing (1719–1745), a German professor for medicine in Giessen. [2] [3]

Clinical significance

Knowledge of basic anatomic and the variations of suspensory ligament of the spleen is essential in the case of open surgery or laparoscopic splenectomy. [4] Moreover, during some surgical procedures, in many cases it is necessary to exert a certain degree of traction on the spleen and on its peritoneal insertions. This traction may result in a rupture of the fibrous capsule of the organ, resulting in severe bleeding which is difficult to control. Particularly hazardous is the downward traction of the phrenicocolic ligament (this maneuver may be necessary for the mobilization of splenic flexure).[ citation needed ] This ligament marks the site where the colon exits the peritoneal cavity: the phrenicocolic ligament is thus an important point of intersection of abdominal anatomy and, consequently, a crucial point for the spread of abdominal disease. [5]

Related Research Articles

<span class="mw-page-title-main">Spleen</span> Organ recycling old red blood cells and also housing lymphocytes

The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes from Ancient Greek σπλήν (splḗn).

<span class="mw-page-title-main">Mesentery</span> Contiguous fold of tissues that supports the intestines

In human anatomy, the mesentery, an organ that attaches the intestines to the posterior abdominal wall, comprises the double fold of the peritoneum. It helps in storing fat and allowing blood vessels, lymphatics, and nerves to supply the intestines.

<span class="mw-page-title-main">Suspensory muscle of duodenum</span> Muscle between the duodenum and jejunum

The suspensory muscle of duodenum is a thin muscle connecting the junction between the duodenum and jejunum, as well as the duodenojejunal flexure to connective tissue surrounding the superior mesenteric and coeliac arteries. The suspensory muscle most often connects to both the third and fourth parts of the duodenum, as well as the duodenojejunal flexure, although the attachment is quite variable.

<span class="mw-page-title-main">Lesser omentum</span> Double layer of peritoneum in the abdomen

The lesser omentum is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into these two connecting parts: the hepatogastric ligament, and the hepatoduodenal ligament.

<span class="mw-page-title-main">Splenic injury</span> Injury to the spleen

A splenic injury, which includes a ruptured spleen, is any injury to the spleen. The rupture of a normal spleen can be caused by trauma, such as a traffic collision.

<span class="mw-page-title-main">Hepatic artery proper</span> Artery supplying blood to the liver and gallbladder

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<span class="mw-page-title-main">Cystic artery</span>

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<span class="mw-page-title-main">Colic flexures</span> Two abrupt bends in the large intestine

In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Note that "right" refers to the patient's anatomical right, which may be depicted on the left of a diagram.

<span class="mw-page-title-main">Greater omentum</span> Fat sheath under abdominal wall

The greater omentum is a large apron-like fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and doubles back to ascend to the transverse colon before reaching to the posterior abdominal wall. The greater omentum is larger than the lesser omentum, which hangs down from the liver to the lesser curvature. The common anatomical term "epiploic" derives from "epiploon", from the Greek epipleein, meaning to float or sail on, since the greater omentum appears to float on the surface of the intestines. It is the first structure observed when the abdominal cavity is opened anteriorly.

<span class="mw-page-title-main">Duodenojejunal flexure</span> Border between the duodenum and the jejunum

The duodenojejunal flexure or duodenojejunal junction, also known as the angle of Treitz, is the border between the duodenum and the jejunum.

<span class="mw-page-title-main">Round ligament of liver</span> Attaches the liver to the abdominal wall

The round ligament of the liver, ligamentum teres or ligamentum teres hepatis is a ligament that forms part of the free edge of the falciform ligament of the liver. It connects the liver to the umbilicus. It is the remnant of the left umbilical vein. The round ligament divides the left part of the liver into medial and lateral sections.

<span class="mw-page-title-main">Trocar</span> Medical or veterinary device

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Hemoperitoneum is the presence of blood in the peritoneal cavity. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Hemoperitoneum is generally classified as a surgical emergency; in most cases, urgent laparotomy is needed to identify and control the source of the bleeding. In selected cases, careful observation may be permissible. The abdominal cavity is highly distensible and may easily hold greater than five liters of blood, or more than the entire circulating blood volume for an average-sized individual. Therefore, large-scale or rapid blood loss into the abdomen will reliably induce hemorrhagic shock and, if untreated, may rapidly lead to death.

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In human anatomy, the median umbilical ligament is an unpaired midline ligamentous structure upon the lower inner surface of the anterior abdominal wall. It is covered by the median umbilical fold.

The paracolic gutters are peritoneal recesses – spaces between the colon and the abdominal wall.

<span class="mw-page-title-main">Gastrosplenic ligament</span> Ligament between stomach and spleen

The gastrosplenic ligament is part of the greater omentum extending between the stomach and the spleen. It contains several blood vessels.

<span class="mw-page-title-main">Accessory spleen</span> Small nodule found apart from the main body of the spleen

An accessory spleen is a small nodule of splenic tissue found apart from the main body of the spleen. Accessory spleens are found in approximately 10 percent of the population and are typically around 1 centimetre in diameter. They may resemble a lymph node or a small spleen. They form either by the result of developmental anomalies or trauma. They are medically significant in that they may result in interpretation errors in diagnostic imaging or continued symptoms after therapeutic splenectomy. Polysplenia is the presence of multiple accessory spleens rather than one normal spleen.

<span class="mw-page-title-main">Wandering spleen</span> Medical condition

Wandering spleen is a rare medical disease caused by the loss or weakening of the ligaments that help to hold the spleen stationary.

<span class="mw-page-title-main">Peritoneal recesses</span>

Peritoneal recesses are the spaces formed by peritoneum draping over viscera.

An exploratory laparotomy is a general surgical operation where the abdomen is opened and the abdominal organs are examined for injury or disease. It is the standard of care in various blunt and penetrating trauma situations in which there may be life-threatening internal injuries. It is also used in certain diagnostic situations, in which the operation is undertaken in search of a unifying cause for multiple signs and symptoms of disease, and in the staging of some cancers.

References

  1. PD-icon.svgThis article incorporates text in the public domain from page 1158 of the 20th edition of Gray's Anatomy (1918)
  2. Hensing ligament in The Free Dictionary by Farlex, Medical Eponyms, Farlex, 2012.
  3. Friedrich W. Hensing in The Free Dictionary by Farlex, Medical Eponyms, Farlex, 2012.
  4. Poulin EC, Thibault C (October 1993). "The anatomical basis for laparoscopic splenectomy". Can J Surg. 36 (5): 484–8. PMID   8221408.
  5. Meyers MA, Oliphant M, Berne AS, Feldberg MA (June 1987). "The peritoneal ligaments and mesenteries: Pathways of intraabdominal spread of disease". Radiology. 163 (3): 593–604. doi:10.1148/radiology.163.3.3575702. PMID   3575702.