Practically all organs of the human body are covered with a thin transparent tissue that prevents them from rubbing against each other, performs a trophic function, absorbs excess fluid and helps maintain the constancy of the internal environment. This tissue is called the peritoneum, and in some places, such as the anterior surface of the intestine, it forms something like an apron.
Large and small oil seal
In the process of evolution, man got on his feet, and this made his stomach and internal organs defenseless. In order to reduce their possible trauma, an additional organ was formed. The greater omentum is a duplication of the peritoneum (four sheets), which starts from the lateral surface of the stomach and descends to the transverse colon. This part of the anatomist is called the gastrointestinal ligament. It contains blood vessels and nerves. The free edge of the omentum descends and, like an apron, covers the loops of the small intestine. The duplication of the peritoneum also goes behind the transverse colon, weaving into the mesentery, and then into the parietal peritoneum.
The space between the sheets of connective tissue is filled with fatty tissue. This provided the specific name of the organ - a largestuffing box. The anatomy of the lesser omentum is somewhat different from the structure of its "older" brother. The lesser omentum consists of three ligaments that merge into one another:
- hepatoduodenal (starts from the gate of the liver to the horizontal branch of the duodenum);
- hepatic-gastric (from the liver to the lesser curvature of the stomach);
- diaphragm bond.
Stuffing bag
This is a large gap formed by the peritoneum. Ahead of the bag is limited by the posterior wall of the stomach, the lesser and greater omentum (gastrointestinal ligament). Behind is the parietal sheet of the peritoneum, the area of the pancreas, the inferior vena cava, the upper pole of the kidney and the adrenal gland. Above is the caudate lobe of the liver, and below is the mesentery of the transverse colon.
In the stuffing bag there is a cavity called the Winslowy hole. The significance of this organ, like the rest of the omentum, is that in case of injuries to the abdominal cavity, it closes the damage, preventing the infection from spreading throughout the body, and also prevents eventration of the organs. If an inflammatory process occurs, such as appendicitis, then the omentum is soldered to the visceral peritoneum and limits the organ or part of it from the rest of the abdominal cavity.
Gland removal
Removal of the greater omentum is not an independent operation, but part of the treatment of oncological diseases of the intestinal tube. This step is done in order to destroy all metastases, which are found in large numbers in the thickness of the peritoneum. It is not advisable to delete them one by one.
An important feature is that the abdominal cavity is opened with a wide longitudinal incision to provide good access to the surgical wound. If the greater omentum is removed through a transverse approach, then there is a danger of leaving the affected area and provoking a relapse of the disease. There will be no consequences for the body after the removal of this organ.
Omental tumors
There is such a thing as primary tumors of the omentum. They are benign (cysts, dermoids, lipomas, angiomas, fibromas, etc.) and malignant (sarcomas, endothelioma, cancer). Secondary formations manifest themselves as metastases from the stomach or intestines, as well as any other organ. In the terminal stage of the disease, the greater omentum is densely covered with altered lymph nodes and neoplasms. It takes the form of a wrinkled roller and is easily determined by deep palpation of the abdominal wall. This phenomenon can cause intestinal obstruction.
Benign tumors of the omentum are quite rare. They do not cause discomfort to patients, so they can reach significant sizes. It is difficult to diagnose them: there are no specific symptoms, markers, or any other indicators. Of the malignant tumors, sarcomas are the most common. They manifest themselves as a syndrome of intoxication, as well as stool retention and weight loss. These warning signs should lead the doctor to think about cancer.
Tight gland syndrome
Large-diameter omentums appear due to the developing inflammatory process. Parts of the organ grow together with the peritoneum in various areas of the abdominal cavity and stretch it. Such adhesions can develop after surgery, with chronic inflammation of the genitourinary system.
Stretching the omentum causes pain and obstructs the patency of the intestinal tube. Most often, patients complain of constant pain in the navel and above the bosom after eating, as well as bloating and vomiting. A characteristic symptom of the disease is an increase in pain if the patient tries to bend back. The final diagnosis is made after ultrasound, computed tomography, radiographs. The ideal option for diagnosis is laparoscopic surgery. If necessary, access can be expanded and spikes removed.
Omental cyst
A cyst occurs due to obstruction of the lymphatic vessels or as a result of the growth of an obliterated area of the lymphoid tissue, which is not connected with the general system. These cysts resemble thin round sacs filled with a clear liquid. Their size can vary from five millimeters to several centimeters. The disease does not manifest itself in any way, but when the formation reaches a significant size, it can be felt through the anterior abdominal wall.
The treatment of this pathology is exclusively surgical. Remove cysts and omentum area, keeping most of it. The prognosis for such patients is favorable.
