Home >> Surgery >> ForumTopic: Perforating Peptic ulcer
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| superbdoc Total Posts: 273 | Posted: Mon Oct 13, 2008 09:42 pm A posteriorly perforating ulcer in the pyloric antrum of the stomach is likely to produce initial localized peritonitis or abscess formation in the ? A) Greater sac B) Left subhepatic and hepatorenal spaces (pouch of Morrison) C) Omental bursa D) Right subphrenic space Ans given is C...Kindly discuss in detail... |
| juhidr Total Posts: 149 | Posted: Mon Oct 13, 2008 09:58 pm Omental bursa is the other name of lesser sac. Lesser sac lies deep to stomach, Greater sac lies anterior to stomach. So anything on posterior surface of stomach will leak to lesser sac. (Just recall the peritoneal reflections of lesser and greater omentum and you will be able to understand it). |
| jemzcal Total Posts: 127 | Posted: Mon Oct 13, 2008 10:04 pm the catch in the question is INITIAL, which is why the answer is so. after the lesser sac/omental bursa is involved it will go on to affect the pouch of morrisson and the other areas. |
| juhidr Total Posts: 149 | Posted: Mon Oct 13, 2008 10:09 pm Point Noted Buddy  |
| superbdoc Total Posts: 273 | Posted: Tue Oct 14, 2008 01:22 am thanx to both of you for your valuable discussion...I have written them in my brain....  |
| superbdoc Total Posts: 273 | Posted: Tue Oct 14, 2008 01:30 am To summarise,Posteroinferior surface (Stomach bed) * The bed of the stomach is formed by the posterior wall of the omental bursa, and retroperitoneal structures between it and the posterior abdominal wall. * Superiorly: part of the diaphragm (left crus), the spleen, the left suprarenal gland and upper pole of the left kidney. * Inferiorly: body and tail of pancreas, transverse mesocolon, left colic flexure and the splenic artery. |