Human Anatomy 101 - What you need to know - Peritoneum

Learning goals
 The participant can describe and schematically draw the arising of intraperitoneal
structures, mesenteries and the peritoneal cavity according to the ‘balloon model’.
 The participant can describe that the foregut is connected to the body wall with a ventral
and a dorsal connection, called mesenteries, and the midgut and hindgut are connected
to the body wall with a only a dorsal mesentery.
 The participant can roughly describe the intraperitoneal and retroperitoneal
compartments of the abdomen

The peritoneum and the gut

When you look at the abdomen of a full grown human, the organization of all the organs and
membranes looks very complex. But when the digestive system develops, it all starts with one
big tube starting at the area that will later become the mouth, leading through the centre of the
body all the way to the bottom.

Figure 1 The 'balloon model' of peritoneal development

In front of this tube lies the abdominal cavity, which is covered with a membranous layer that is
called the peritoneum (figure 1, left). If you depict the abdominal cavity like a balloon, you can
imagine that when you press the gut-tube into the back side of the balloon, the balloon will bend
around the tube (figure 1, right). The gut-tube is now covered with a layer or peritoneum, which
is still continuous with the part covering the abdominal wall. At the dorsal side of the tube the
two layers that were drawn along with the gut, stick together, thereby covering the blood vessels
leading to the gut, as shown in figure 1, right. We now distinguish three parts of the peritoneum.
First we have the part that covers the wall of the abdominal cavity: the parietal peritoneum.
Secondly there is the part that covers the gut-tube: the visceral peritoneum. And finally there is
a part between the visceral and parietal peritoneum, that connects the gut with the body wal.
This part is called a mesentery.
As the intestines further develop, they will grow so long that they need to be twisted and folded
to fit inside the abdomen. Although the organisation looks more complex, the entire intestine is
still connected to the dorsal abdominal wall by the mesentery.

Figure 2 The embryonic gut tube and its mesenteries

All the way from the abdominal part of the oesophagus down to the first part of the rectum,
there's a mesentery at the back side of the gut-tube, the dorsal mesentery (figure 2). The part of
the tube that will later become the stomach also has a mesentery at the front side of the gut-
tube, the ventral mesentery. The liver develops inside the ventral mesentery, effectively splitting
it into two parts (figure 2).

So we have seen that all the organs that developed from the original gut-tube are surrounded by
a layer of peritoneum. We say that these organs are intraperitoneal. However, other organs, like
the kidneys, develop behind this layer of peritoneum, and are not pushed inward (figure 3). They
lie next to the dorsal abdominal wall. These organs are said to be retroperitoneal (retro =
behind).

Figure 3 Retroperitoneal sructures