FACTS & HINTS

High-Yield Facts

Anatomic Points

The greater omentum is often referred to as the "abdominal policeman." It can move within the peritoneal cavityand wrap itself around an inflamed organ, localizing inflammation and preventing adhesion between the visceral peritoneum and parietal peritoneum of the abdominal wall.

page 140

page 141

There are several ways to access the omental bursa surgically:

Directlythrough the lesser omentum

Through the transverse mesocolon

Through the gastrocolic ligament (part of the greater omentum)

Clinical Points

Peritonitis

Inflammation of the peritoneum

Can be localized (e.g., secondaryto appendicitis) or generalized (e.g., secondaryto bowel perforation)

Can result in reflextensing ("guarding") of the overlying abdominal musculature leading to abdominal rigidity.

Involvement of parietal peritoneum leads to well-localized, sharp abdominal pain with tenderness on palpation.

Ascites

Accumulation of fluid in the peritoneal cavity

Mayform secondaryto peritonitis or a varietyof other pathological conditions

Abdomen maybecome grosslydistended as manyliters of fluid accumulate

Paracentesis maybe undertaken both for diagnostic purposes and for draining the ascitic fluid.

Usuallyperformed under local anaesthesia.

210 / 425