[edit] Subdivisions
If
Extragastrointestinal stromal tumors, by definition, arise from
outside the GI tract but histologically resemble their GI
counterparts. In general, they are an aggressive group of tumors
sharing a similarity to GI stromal tumors (GIST) arising in the
distal GI tract. One of the larger studies of 48 cases found a
female predominance (32F 16M) with an age range of 31-82
years (mean 58 years). The majority arose from the soft tissue of
the abdominal cavity while the remainder arose from the
retroperitoneum. The size ranged from 2-32 cm.
Under the microscope, the tumors showed characteristic changes
of GIST with tumors having rounded epithelioid cells to spindled
cells with a fine fibrillary background and varying amounts of
myxoid and hyalinized stroma. Immuhohistochemical analysis
revealed the following staining pattern:
The greater omentum (also the great omentum, omentum majus
, gastrocolic omentum, epiploön, or, especially in animals, caul)
is a large fold of peritoneum that hangs down from the stomach,
and extends from the stomach to the posterior abdominal wall
after associating with the transverse colon.
Structure
The greater omentum is the largest peritoneal fold. It consists of
a double sheet of peritoneum, folded on itself so that it is made
up of four layers.
The two layers which descend from the greater curvature of the
stomach and commencement of the duodenum pass in front of
the small intestines, sometimes as low down as the pelvis; they
then turn upon themselves, and ascend again as far as the
transverse colon, where they separate and enclose that part of
the intestine.
These individual layers may be easily demonstrated in the young
subject, but in the adult they are more or less inseparably
blended.
The left border of the greater omentum is continuous with the
gastrolienal ligament; its right border extends as far as the
commencement of the duodenum.
The greater omentum is usually thin, presents a cribriform
appearance, and always contains some adipose tissue, which in
obese people accumulates in considerable quantity.
Between its two anterior layers, a short distance from the greater
curvature of the stomach, is the anastomosis between the right
and left gastroepiploic vessels.
The greater omentum can often be found wrapped around areas
of infection and trauma.
taken out to see if they contain cancer spread from the ovary.
The greater omentum is often defined to encompass a variety of there is fluid in the pelvis or abdominal cavity, it will also be
structures. Most sources include the following three:[1][2] removed for analysis. The surgeon may "wash" the abdominal
cavity with salt water (saline) and send that fluid for analysis. All
• Gastrocolic ligament - to transverse colon (occasionally the tissue and fluid samples taken during the operation are sent
on its own considered synonymous with "greater to a lab to be examined for cancer cells. Staging is very
omentum"[1]) important because ovarian cancers at different stages are
treated differently. If the staging isn't done correctly, the doctor
• Gastrosplenic ligament - to spleen
may not give the right treatment.
• Gastrophrenic ligament - to thoracic diaphragm
The splenorenal ligament (from the left kidney to the spleen) is
occasionally considered part of the greater omentum.[3][4]
The greater omentum develops from the dorsal mesentery that
connects the stomach to the posterior abdominal wall. During
stomach development, the stomach undergoes its first 90°
rotation along the axis of the embryo, so that posterior structures
are moved to the left and structures anterior to the stomach are
shifted to the right. As a result, the dorsal mesentery folds over
on itself, forming a pouch with its blind end on the left side of the
embryo. A second approximately 90° rotation of the stomach,
this time in the frontal plane, moves structures inferior if they
were originally to the left of the stomach, and superior if they
were originally to the stomach's right. Consequently, the blind-
ended sac (also called the lesser sac) formed by the dorsal
mesentery is brought inferiorly, where it assumes its final
position as the greater omentum. It grows to the point that it
covers the majority of the small and large intestine.
greater omentum
A fold of the peritoneum, passing from the stomach to the
transverse colon. Also called caul.
. In addition, the omentum is also removed (an omentectomy).
The omentum is a layer of fatty tissue that covers the abdominal
contents like an apron, and ovarian cancer sometimes spreads to
this tissue. Some lymph nodes in the pelvis and abdomen are