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Colonic Anatomical Relations (Peritoneum & Adjacent Organs), Medial,…
Colonic Anatomical Relations (Peritoneum & Adjacent Organs)
Peritoneal Relations & Fixation Ligaments (Mobile vs. Retroperitoneal Segments)
Mobile Segments
Cecum & Appendix
Mobile in the greater peritoneal cavity
Completely enveloped in visceral peritoneum
Transverse Colon
Pelvic (Sigmoid) Colon
Forming the Pelvic Mesocolon (Mesosigmoid)
Completely enveloped in visceral peritoneum
Fixed Segments & Fusion Fasciae
Ascending Colon & Right Colic Angle
Adherent retroperitoneal
Adherence forms the Right Toldt Fascia
Right Angle Anchors (connects to liver/gallbladder) :
Phrenicocolic Ligament
Cholecystocolic Ligament
Left Colic Angle, Descending & Iliac Colon
Adherent with their mesocolon to posterior parietal peritoneum, forming the Left Toldt Fascia
Left Angle Anchor: Left Phrenicocolic Ligament (attaches to the thoracic diaphragm)
Relations With Adjacent Organs (Segmental Topography)
Colic Flexures & Transverse Colon
Left Colic Angle (Splenic Flexure): Posterior to Greater Curvature of Stomach; anterior to Left Kidney & Pancreatic Tail; lateral/superior to Spleen & Diaphragm
Right Colic Angle (Hepatic Flexure): Posterior to Liver; anterior to Right Kidney; medial to D2 (Descending Duodenum)
Transverse Colon:
Inferior
Small-intestinal loops
Posterior
Duodenopancreatic complex, both kidneys
Anterior/Superior:
Liver, stomach, anterior abdominal wall, greater omentum
Left-Sided & Pelvic Segments (Descending, Iliac & Sigmoid)
Descending Colon
Posterior to lumbar fossa; anterior to small intestine loops; medial to Left Ureter & Gonadal Vessels
Pelvic (Sigmoid) Colon
Posterior
External iliac vessels
Anterior/Inferior
Urinary bladder (and Uterus in females)
Iliac Colon
Lies in left iliac fossa anterior to Iliopsoas Muscle; medial to Left Ureter & Gonadal Vessels
Right-Sided Segments (Cecum & Ascending)
Cecum & Appendix
Anterior
Anterior abdominal wall
Ascending Colon
Posterior
Right kidney
Psoas muscle
Quadratus Lumborum
Medial
Right ureter
Right Gonadal Vessels
Medial
Ileal loops
Right ureter
Iliac vessels
Lateral
Right iliac fossa
Lateral abdominal wall
Mobile; attached to posterior wall by the Transverse Mesocolon
Connected to stomach via the Gastrocolic Ligament (part of greater omentum)
Posterior
Iliopsoas muscle