The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative AnatomyHuntington, George S. (George Sumner)
Science
The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative Anatomy
Huntington, George S. (George Sumner)
Abdomen; Peritoneum
Fig. 164 shows the appearance of the fold in _Nasua rufa_ after rotation
of the intestine. The short course of the large intestine in this
animal, and the consequent reduction of the mesocolon, brings the fold
much below the level which it occupies in the cat.
[Illustration: FIG. 164.--Abdominal viscera of _Nasua rufa_, the brown
coaiti, showing the position of the duodenal fold after rotation of the
intestine. (From a fresh dissection.)]
If we now look for the corresponding structures in man we will find
certain modifications depending chiefly upon still closer adhesion
between duodenum and the mesocolon which is destined to become the left
parietal peritoneum after anchoring of the descending colon. We have
already encountered an example of such closer connection in the marmoset
shown in Fig. 162.
In all cases the "superior duodenal" fold, corresponding to the fold
just encountered in the cat, is the original condition, and the duodenal
fossa consequently opens caudad. In many instances this will be the only
fold and fossa encountered in the adult human subject. In other
instances more extensive duodeno-mesocolic adhesions result in the
addition of an "inferior fold," bounding a fossa the entrance into which
is directed cephalad toward the transverse mesocolon. Such a condition
is seen in Fig. 165 taken from a foetus at term. The duodenal fossa in
this case is bounded by an "upper" and "lower" duodenal fold continuous
with each other on the left side, but separated on the right at their
attachment to the duodenum. It will be seen that the inferior mesenteric
vein runs in the left margin of the fold, following along the left
border of the entrance into the fossa. A segment of the colica sinistra
artery may occupy the same position. This position of the vein, or
artery, or of both vessels, is not the cause leading to the formation of
the duodenal fossa, but is more or less accidental and variable. In many
cases the vessels run at some distance from the folds bounding the
fossa.
[Illustration: FIG. 165.--Abdominal viscera of human foetus at term,
arranged to show duodenal folds and fossa. The jejuno-ileum, ascending
and transverse colon have been removed. (Columbia University Museum, No.
1819.)]
In some subjects the "inferior" fold is the only one found, and the only
duodenal fossa then encountered looks cephalad. This condition, when
associated with the course of the inferior mesenteric vessels in the
free edge of the fold, constituted the classical "fossa
duodeno-jejunalis" of Treitz, and is described as "Treitz's fossa."
Fig. 166 shows the condition in which only a small inferior fold
attaches itself to the termination of the transverse duodenum. There is
practically an entire absence of duodenal or duodeno-jejunal folds and
fossae. The inferior mesenteric vessels course under cover of the
mesocolic secondary parietal peritoneum, but do not produce a fold.
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