Almost 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 a constant internal environment. This tissue is called the peritoneum, and in some places, for example along the front surface of the intestine, it forms something like an apron.
Big and small oil seal
In the process of evolution, a man stood on his feet, and this made his stomach and internal organs defenseless. In order to reduce their possible trauma, an additional organ was formed. A large omentum is a duplicate of the peritoneum (four leaves), which begins from the lateral surface of the stomach and descends to the transverse colon. This section of the anatomy is called the gastrointestinal ligament. It contains vessels and nerves. The free edge of the omentum descends lower and, like an apron, covers the loops of the small intestine. A duplicate of the peritoneum also goes behind the transverse colon, interwoven 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 large omentum. The anatomy of the omentum is somewhat different from the structure of his "older" brother. Small epiploon consists of three ligaments that pass one into another:
- hepatoduodenal (starting 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);
- aperture ligament.
Stuffing bag
This is a large gap formed by the peritoneum. In front of the bag, the back wall of the stomach, small and large omentum (gastrointestinal ligament) limit the bag. The parietal sheet of the peritoneum, the area of the pancreas, the inferior vena cava, the superior pole of the kidney and the adrenal gland are located behind. At the top is the caudate lobe of the liver, and below is the mesentery of the transverse colon.
The stuffing box has a cavity called the Vinslovi hole. The significance of this organ, as well as the rest of the omentum, boils down to the fact that in case of injuries of the abdominal cavity, it closes the damage, preventing the infection from spreading throughout the body, and also prevents eventing of organs. If an inflammatory process occurs, such as appendicitis, then the omentum fuses with 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 cancer of the intestinal tube. This step is done in order to destroy all metastases that are found in large numbers in the thickness of the peritoneum. Removing them one at a time is not advisable.
An important feature is that the abdominal cavity is opened with a wide longitudinal section to allow good access to the surgical wound. If a large omentum is removed through transverse access, 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.
Gland tumors
There is such a thing as primary omentum tumors. They are benign (cysts, dermoids, lipomas, angiomas, fibromas and others) and malignant (sarcomas, endotheliomas, 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, a large omentum is densely covered with altered lymph nodes and neoplasms. It takes the form of a wrinkled cushion and is easily determined with deep palpation of the abdominal wall. This phenomenon can cause bowel obstruction.
Benign tumors of the omentum - a phenomenon quite rare. They do not cause discomfort to patients, therefore, 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 most common. They manifest themselves intoxication syndrome, as well as stool retention and weight loss. These warning signs should prompt the doctor to think about cancer.
Stuffing box syndrome
Glands of large diameter appear due to the developing inflammatory process. Parts of the organ fuse 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 disrupts the patency of the intestinal tube. Most often, patients complain of constant pain in the navel and above the womb after eating, as well as bloating and vomiting. A characteristic symptom of the disease is increased pain if the patient tries to bend back. The final diagnosis is made after ultrasound, computed tomography, radiographs. An ideal option for diagnosis is laparoscopic surgery. If necessary, access can be expanded and adhesions removed.
Omental cyst
The cyst occurs due to obstruction of the lymphatic vessels or as a result of the growth of the obliterated area of 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 front abdominal wall.
The treatment of this pathology is exclusively surgical. Cysts and the omentum region are removed, preserving most of it. The prognosis for such patients is favorable.