The lesser sac (omental bursa) communicates with the greater sac via the epiploic foramen (of Winslow). If a pancreatic pseudocyst ruptures into the lesser sac, fluid spread is initially contained. What are the boundaries of the epiploic foramen?
- A Anterior: falciform ligament; Posterior: abdominal aorta; Superior: right lobe of liver; Inferior: transverse colon
- B Anterior: gastrocolic ligament; Posterior: pancreas; Superior: left lobe of liver; Inferior: mesocolon
- C Anterior: free edge of lesser omentum (hepatoduodenal ligament containing portal triad); Posterior: IVC; Superior: caudate lobe of liver; Inferior: 1st part of duodenum ✓
- D Anterior: lesser omentum; Posterior: aorta; Superior: diaphragm; Inferior: splenic flexure
Correct answer: C. Anterior: free edge of lesser omentum (hepatoduodenal ligament containing portal triad); Posterior: IVC; Superior: caudate lobe of liver; Inferior: 1st part of duodenum
Explanation
The epiploic foramen (of Winslow) is the communication between the greater and lesser peritoneal sacs. Its boundaries: anterior = free edge of lesser omentum (hepatoduodenal ligament containing portal vein, hepatic artery, and common bile duct); posterior = IVC (covered by peritoneum); superior = caudate lobe of liver (hepatic segment I); inferior = first part of duodenum. In portal hypertension, the portal vein in this ligament becomes engorged. Pringle maneuver (clamping the hepatoduodenal ligament) controls hepatic inflow by occluding this foramen's anterior boundary.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.