Summary of lesser sac : lecture note

Lesser sac

•      It is the part of peritoneal cavity  behind Liver, lesser omentum,  the stomach, & 1^st two layers of greater omentum .  

•      Parts of lesser sac

•      Vestibule

•      Three recesses : superior, inferior and left

•      One opening  : epiploic foramen

•      Body : It has

1.      Two walls: anterior and posterior

2.      Four borders: superior, inferior , right and left 

•      Vestibule of lesser sac

•      It is a constricted area immediately left of the epiploic foramen situated in between right and left gastropancreatic fold of peritoneum  

•      Recesses of lesser sac :

Superior recess is situated just behind the caudate lobe of the liver

Inferior recess :
is formed by the junction between two anterior layers of greater omentum with its posterior two layers.

Splenic recess:  is situated in between gastrosplenic and lienorenal ligament

•      Body of lesser sac

•      Borders of lesser sac

•      Right border : epiploic foramen , peritoneal reflexion from the surface of 1^st part of duodenum to head of pancreas,Right border of greater omentum 

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•  Left border : gastrophrenic ligament , gastrosplenic ligament and left border of greater omentum 
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•      Inferior border : Is formed by the junction between two anterior layers of greater omentum with its posterior two layers. 

•   Superior border : Is formed by the peritoneum extending from the caudate lobe of liver to  the diaphragm 
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Boundaries of body of lesser sac :

Anterior wall :

•        from above downward,

•      By the caudate lobe of the liver,

•       the lesser omentum,

•      back of the stomach

•      The anterior two layers of the greater omentum

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Posterior wall :

From above downward

•      The upper end of the left kidney

•      The left suprarenal gland

•      The upper surface of the pancreas

•      The ascending layer of the transverse mesocolon

•      The transverse colon

•      By the posterior two layers of the greater omentum, 

Clinical anatomy :

•      A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue, typically located in the lesser sac of the abdomen. Pancreatic pseudocysts are usually complications of pancreatitis

•      Surgical access of lesser sac

1.      Through lesser omentum

2.      Through Gastrocolic ligament (part of greater omentum )

3.      Through transverse mesocolon

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