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胃脾韌帶 ? Gastrophrenic ligament 胃膈韌帶 ? Gastrocolic ligament 胃結(jié)腸韌帶 ? Gastropancrestic ligament 胃胰韌帶 2022/2/2 add footer here (go to view menu and choose header) 12 脾的韌帶 ? 胃脾韌帶 -如前所述 ? 脾腎韌帶 -是自脾門至左腎前面的雙層腹膜結(jié)構(gòu),內(nèi)含胰尾及脾血管、淋巴結(jié)構(gòu)和神經(jīng)叢等。 2022/2/2 add footer here (go to view menu and choose header) 24 1 = peritoneal reflection of cava forming roof of foramen of Winslow。 3 =medial segment of left inferior coronary ligament。 5 = gastrophrenic ligament。 7 = splenorenal ligament。 2022/2/2 add footer here (go to view menu and choose header) 25 Lesser sac CT scan shows fluid in the superior (*) and splenic (S) recesses of lesser sac outlining the gastropancreatic fold (arrowhead). Company Logo 26 肝裸區(qū) ?于第一肝門以上平面,可見此間隙位于冠狀韌帶上、下層之間。 Company Logo 27 肝周積液與胸腔積液鑒別 右肝上前間隙積液 右側(cè)胸腔積液 2022/2/2 add footer here (go to view menu and choose header) 28 胃裸區(qū) Bare area of stomach ? 是否侵犯胃裸區(qū)是胃癌預后的影響因素之一 2022/2/2 add footer here (go to view menu and choose header) 29 2022/2/2 add footer here (go to view menu and choose header) 30 2/2/2022 add footer here (go to view menu and choose header) 31 Infracolic partments 結(jié)腸下區(qū) -位于橫結(jié)腸及橫結(jié)腸系膜以下 ? Right paracolic sulcus (gutter) 右結(jié)腸旁溝 -位于升結(jié)腸旁,是聯(lián)系肝腎隱窩和盆腔的通路;感染可通過此途徑傳播,如膈下膿腫可經(jīng)此溝流入右髂窩和盆腔,闌尾化膿時也可向上蔓延至肝下 ? Left paracolic sulcus (gutter) 左結(jié)腸旁溝 -位于降結(jié)腸旁,上緣由左膈結(jié)腸韌帶( the phrenicocolic ligament)與結(jié)腸上區(qū)分隔 , 因此左結(jié)腸旁溝積液只能向下流入盆腔 2/2/2022 add footer here (go to view menu and choose header) 32 ? Right mesenteric sinus 右腸系膜竇 - 為一三角形間隙,位于腸系膜根部、升結(jié)腸及右 2/3 橫結(jié)腸及其系膜之間,其下方有回腸末端阻隔,近乎封閉,當此竇有炎癥時,不易擴散,易形成腸間膿腫或局限性腹膜炎 ? Left mesenteric sinus 左腸系膜竇 - 為向下開口的斜方形,位于腸系膜根部、降結(jié)腸、左 1/3 橫結(jié)腸及其腸系膜之間,左腸系膜竇可向下越過小骨盆口通入盆腔,因此此竇內(nèi)感染易蔓延入盆腔 ? 上下流通,左溝不暢,右竇封閉,左入盆腔。 ? 組成:腎旁前間隙;腎周間隙;腎旁后間隙 2022/2/2 add footer here (go to view menu and choose header) 34 腎周間隙 ? 腎周間隙上方 — 右側(cè)通向肝裸區(qū);左側(cè)通向左膈下腹膜外間隙 ? 腎周間隙下方 — 通向下腹部及盆腔腹膜外間隙(髂窩) ? 雙側(cè)腎周間隙之間 — 腎門及腸系膜上動脈平面以下腎前間隙相交通,以上不交通 2022/2/2 add footer here (go to view menu and choose header) 35 Retroperitoneal space 2022/2/2 add footer here (go to view menu and choose header) 36 2022/2/2 add footer here (go to view menu and choose header) 37 病 例 ? 網(wǎng)膜囊病變 ? 腹膜病變 :漏出液、炎性滲出、血腫、膽漏、尿漏 2022/2/2 add footer here (go to view menu and choose header) 38 Fig. of lesser sac anatomy by ascites. A, Patient with alcoholic cirrhosis. Fluid within lesser and greater peritoneal cavities outli