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27.2 : Peritoneum

The peritoneum is a vital membrane that lines the abdominal cavity and covers most of the organs within it. It plays a crucial role in protecting the organs, providing a smooth surface for their movement, and facilitating various physiological processes. Understanding the anatomy and function of the peritoneum is essential for comprehending the complexities of the abdominal region.

Anatomy of the Peritoneum

The peritoneum is divided into two layers: the parietal peritoneum and the visceral peritoneum. The parietal peritoneum lines the inner surface of the abdominal wall, while the visceral peritoneum covers the abdominal organs.

Parietal Peritoneum

The parietal peritoneum is further divided into different regions based on its location in the abdominal cavity. These regions include:

Diaphragmatic peritoneum: It lines the inferior surface of the diaphragm, which separates the abdominal and thoracic cavities.

Pelvic peritoneum: Found in the lower area of the abdomen, extending into the pelvis.

Posterior abdominal wall peritoneum: Lines the posterior abdominal wall.

Visceral Peritoneum

The visceral peritoneum encapsulates the abdominal organs, covering them entirely or partially. It forms folds and attachments known as peritoneal ligaments and mesenteries, which provide support and stability to the organs.

Peritoneal Folds

Greater Omentum: The greater omentum is a large fold that hangs down from the stomach and wraps around the small intestines. It acts as a protective barrier, isolating infections and inflammation within the peritoneal cavity.

Falciform Ligament: This ligament extends from the liver to the anterior abdominal wall. It separates the right and left lobes of the liver and provides support and stability to the liver.

Lesser Omentum: The lesser omentum connects the stomach and the first part of the duodenum to the liver. It contains important blood vessels and bile ducts, aiding in digestion and nutrient absorption.

Mesentery: The mesentery is a fold that attaches the small intestines to the posterior abdominal wall. It contains blood vessels, nerves, and lymphatics, supplying nutrients to the intestines and facilitating their movement.

Mesocolon: The mesocolon is a fold that connects the colon to the posterior abdominal wall. It provides support and helps maintain the colon's position.

Function of the Peritoneum

The peritoneum serves several important functions within the abdominal cavity:

Protection: The peritoneum acts as a protective barrier, covering and enclosing the organs, preventing injury and infection.

Lubrication: The peritoneal cavity is lined with a thin layer of fluid, known as peritoneal fluid, which reduces friction between the organs and enables smooth movement.

Absorption and Secretion: The peritoneum has absorbent and secretory capabilities, allowing it to absorb nutrients and drugs from the gastrointestinal tract and secrete substances for various physiological processes.

Support and Stability: The peritoneal folds, ligaments, and mesenteries provide structural support and stability to the abdominal organs, preventing displacement or excessive movement.

Immune Response: The peritoneal cavity contains cells of the immune system, such as macrophages, that help defend against infections and foreign substances.

Understanding the anatomy and function of the peritoneum is crucial for medical professionals and researchers. It allows them to diagnose and treat various abdominal conditions, perform surgeries with precision, and comprehend the intricate interplay of organs within the abdominal cavity.

Clinical condition of the peritoneum: Peritonitis:

Peritonitis, a severe inflammation of the peritoneum, often arises from the inadvertent introduction of infection-causing microbes into the peritoneum. This can occur due to unintentional or surgical injuries to the abdominal wall or due to a rupture or perforation of a hollow organ. For instance, if bacteria infiltrate the peritoneal cavity through a tear in the intestine or a ruptured appendix, it can trigger an intense, potentially fatal peritonitis. A milder, albeit discomforting, form of peritonitis can develop when inflamed peritoneal surfaces friction against each other. People who require peritoneal dialysis - a treatment that leverages the peritoneum to purify the blood when the kidneys are incapable of performing their duties - are especially at risk of peritonitis.

From Chapter 27:

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