Abdominal cavity

Last updated: August 10, 2023

Summarytoggle arrow icon

The abdominal cavity is located between the thoracic cavity and pelvic cavity. It is lined by the parietal and visceral peritoneum, and the space between these two layers forms the peritoneal cavity. The peritoneal cavity develops from the intraembryonic coelom, which arises within the lateral plate mesoderm. The abdominal organs (e.g., spleen, kidneys) and structures of the gastrointestinal tract are covered by the peritoneum. The visceral peritoneum folds upon itself to form peritoneal folds, which suspend organs and divide the peritoneal cavity into various compartments (e.g., the greater sac, lesser sac, and subphrenic space). Organs that are completely covered by the visceral peritoneum are referred to as intraperitoneal organs and those that are only partially covered are called retroperitoneal organs. The retroperitoneal space lies between the peritoneal cavity and the posterior abdominal wall. It contains the following structures: abdominal aorta, inferior vena cava, portal vein, abdominal prevertebral plexus, lymph node clusters, lymphatic trunks, and cisterna chyli.

Overviewtoggle arrow icon

Peritoneumtoggle arrow icon

Overview of peritoneum

Peritoneum is a serous mesothelial membrane that lines the abdominopelvic cavity and encloses most intraabdominal and pelvic organs. It consists of two layers, the parietal peritoneum and visceral peritoneum.

Parietal peritoneum

Visceral peritoneum


Omentum is a double layer of visceral peritoneum arising from the stomach and proximal part of duodenum to various abdominal organs.

Peritoneal ligament

Definition: a collection of folds of visceral peritoneum connecting certain gastrointestinal organs to one another and/or to the abdominal wall

Overview of peritoneal ligaments
Ligaments Attachments Content(s) Clinical significance
Stomach and duodenal attachments
Greater omentum Gastrocolic ligament
Gastrosplenic ligament
  • Separates greater and lesser sacs on left side
Gastrophrenic ligament [4]
  • Anchors the stomach to the diaphragm
Lesser omentum Hepatogastric ligament
  • Separates greater and lesser sacs on the right side
  • Cut to access lesser sac during surgery
Hepatoduodenal ligament
Liver attachments
Falciform ligament
Triangular ligaments of the liver (paired)
  • Right: right lobe of liver and inferior surface of diaphragm
  • Left: left lobe of liver and inferior surface of diaphragm
Coronary ligament
  • Does not contain any structures
Ligamentum venosum
  • Does not contain any structures
Spleen attachments and supports
Splenorenal ligament
Phrenicocolic ligament
  • Does not contain any structures


Definition: : a contiguous double-layered fold that anchors bowel to the posterior abdominal wall and allows for passage of neurovascular structures.

Mesentery of small and large intestine
Mesentery Attachment Content Clinical significance
Mesentery of the small intestine
Transverse mesocolon
  • Divides the abdominal cavity into supracolic and infracolic compartments
  • Mesoappendix is dissected during appendectomy to ligate the appendicular vessels.
Sigmoid mesocolon

Parietal peritoneum of the lower anterior abdominal wall

Peritoneum of the pelvis

See “Ligaments of the female pelvis” and “Pelvic spaces.”


  • Compartmentalization of the abdominal cavity to give rise to distinct recesses (e.g., subphrenic recess)
  • Allows for free movement of organs in relation to each other
  • Provides ligament support to organs (e.g., stomach, liver, spleen)
  • Absorption of peritoneal fluid [9]

Peritoneal cavity and spacestoggle arrow icon

Peritoneal cavity

Peritoneal spaces

  • Definition: group of potential spaces between adjacent organs or between an organ and the abdominal wall in which intraperitoneal fluid can accumulate
Peritoneal sacs, foramina, and spaces
Spaces Description Boundaries Clinical significance
Greater sac
  • Surrounds the intraperitoneal organs
  • Divided into supracolic and infracolic compartment by the transverse mesocolon

Lesser sac (omental bursa) [9][10]

Epiploic foramen (foramen of Winslow)

Hepatorenal space (Morison pouch) [10]

  • Space between the inferior surface of the liver and the right kidney
Splenorenal recess (Koller pouch)

Subphrenic space [9]

Paracolic gutters

Disease can rapidly spread through the peritoneal cavity, e.g., in metastatic ovarian cancer or peritonitis. Paracentesis and analysis of peritoneal fluid can help to diagnose diseases affecting the peritoneal cavity.

Fluid from the abdominal cavity can also collect in the pelvic spaces, e.g., the pouch of Douglas. (See “Pelvic spaces.”)

Bowel perforation can lead to pneumoperitoneum. Since gas is not normally present in the peritoneal cavity, this can be detected with an abdominal x-ray.

Peritoneal folds

Retroperitoneumtoggle arrow icon




Retroperitoneal spaces
Spaces Boundaries Content Clinical relevance
Perirenal space

Anterior pararenal space

Posterior pararenal space

  • Fat

Clinical significance

Intraperitoneal and extraperitoneal abdominal structurestoggle arrow icon

Overview of intraperitoneal and retroperitoneal organs
Type of organ Intraperitoneal organs Extraperitoneal organs
Retroperitoneal organs Secondary retroperitoneal organs Subperitoneal organs

SAD PUCKER for the retroperitoneal and secondary retroperitoneal organs: Suprarenal (adrenal) glands, Aorta/IVC, Duodenum (except for the first part), Pancreas (except for the tail), Ureters, Colon (ascending and descending parts), Kidneys, Esophagus, Rectum.

Embryology of the peritoneumtoggle arrow icon

Development of peritoneal cavity [9]

Peritoneum and related structures develop from the lateral plate mesoderm. See “Embryology of the gastrointestinal tract”, “Development of the reproductive system”, and “Kidney embryology” to know more about the development of specific organs of the abdominal cavity.

Development of lesser sac

Development of greater sac

Development of mesentery [9]

Arteries of the abdominal cavitytoggle arrow icon

Abdominal organs and peritoneum are supplied by the branches of abdominal aorta.

Abdominal aortatoggle arrow icon

Overview [9]

The abdominal aorta bifourcates at the level of L4.

Branches of the abdominal aorta [9]
Plane of origin Type Area of supply Branches Vertebral level
  • T12
  • L1
  • L3
  • L1
  • L1–L2
  • L2
  • Paired parietal
  • Diaphragm
  • Body wall
  • T12
  • L1–L4

Paired aortic branches

Paired branches of the abdominal aorta
Main branches



Area of supply

Inferior phrenic artery

  • Runs cranially and ventrally along the inferior aspect of the diaphragm towards its domes
  • Divides into a network of terminal branches
  • Superior suprarenal artery
  • Terminal branches
  • Inferior aspect of the diaphragm

Middle suprarenal artery

  • Terminal branches

Renal artery

  • Inferior suprarenal artery
  • Terminal branches

Gonadal artery

  • Testicular artery
Lumbar arteries
(four on each side)
  • Spinal branches
  • Terminal branches

Unpaired aortic branches

Celiac trunk

The celiac trunk emerges approximately at the level of T12 ; and divides into the three following branches to supply the foregut.

Branches of celiac trunk
Main branches Course Branches and their course Area of supply

Splenic artery

Left gastric artery

  • Direct branches
  • Esophageal branches

Common hepatic artery

  • Right hepatic artery
  • Left hepatic artery

A penetrating peptic ulcer or tumor in the posterior duodenal wall can erode into the gastroduodenal artery, leading to torrential hemorrhage.

Superior mesenteric artery

The superior mesenteric artery emerges from the aorta approx. at the level of L1; and then runs anteriorly and inferiorly, dividing into the following branches to supply the midgut.

Branches of superior mesenteric artery
Main branches Course Branches Area of supply
Inferior pancreaticoduodenal artery

Jejunal artery and ileal artery

Ileocolic artery
  • Runs within the mesentery towards the ileocecal region
  • Anterior cecal artery
  • Posterior cecal artery
  • Appendicular artery

Right colic artery

Middle colic artery

Inferior mesenteric artery

The inferior mesenteric artery emerges at the level of L3 and supplies the hindgut with the following branches.

Branches of inferior mesenteric artery
Main branches Course Branches Area of supply

Left colic artery

Sigmoid arteries

  • Multiple small branches
Superior rectal artery
  • Multiple small branches

Important anastomosestoggle arrow icon

All unpaired branches of the abdominal aorta form an anastomosis to ensure continued perfusion of organs in the event of vascular occlusion.

Clinical significancetoggle arrow icon

Nutcracker syndrome

Celiac artery compression syndrome (median arcuate ligament compression syndrome) [24]

Splenic artery aneurysm [25][26][27]

Other conditions

Veins of the abdominal cavitytoggle arrow icon

There are two systems responsible for venous drainage of the abdominal spaces that merge just before the heart, the inferior vena cava and portal hepatic vein.

Inferior vena cavatoggle arrow icon

Main tributaries of the inferior vena cava
Tributaries Area of drainage Note

Inferior phrenic vein

  • Inferior aspect of the diaphragm

Lumbar veins
(four on each side)

Renal vein (left and right)

Right gonadal vein

  • The left gonadal vein empties into the left renal vein.

Right suprarenal vein

  • The left suprarenal vein typically drains into the left renal vein.

Hepatic veins (right, intermediate, left) [30]

Hepatic portal veintoggle arrow icon

Overview [9]

Main tributaries [1][32][33]

The hepatic portal vein receives blood directly from smaller veins as well as the splenic vein and the superior and inferior mesenteric vein.

Direct tributaries from smaller veins

Main tributaries of the hepatic portal vein
Tributaries Course Area of drainage Note

Left gastric vein

Right gastric vein
Prepyloric vein (via right gastric vein) [34]
Cystic vein [1][36]
Paraumbilical veins
  • None
Superior pancreaticoduodenal vein (posterior division)

Indirect tributaries via large veins

Main tributaries of the splenic vein

Tributaries Course Area of drainage
Pancreatic veins [33]
Short gastric veins
Left gastroepiploic vein
Posterior gastric vein
Inferior mesenteric vein Left colic vein
Sigmoid veins
Superior rectal vein

Main tributaries of superior mesenteric vein

Tributaries Course Area of drainage
Right gastroepiploic vein
Inferior pancreaticoduodenal veins
Jejunal veins and ileal veins
Ileocolic vein
  • Formed by the confluence of cecal vein and appendicular vein
Right colic vein
Middle colic vein

Important anastomoses and collateral circulationtoggle arrow icon


Cavocaval anastomoses [9][37][38]

In the event of IVC obstruction, venous blood can still enter the SVC and right atrium of the heart via the azygos/hemiazygos system or alternative pathways.

Portocaval anastomoses [29]

Patients with portal hypertension can develop varices of the gut (distal esophagus), butt (rectum and anal canal), and caput (medusae).

Clinical significancetoggle arrow icon

Inferior vena cava thrombosis [39]

Other conditions

Lymphatics of the abdominal cavitytoggle arrow icon

Lymphatic drainage of the abdominal cavity occurs via lymph nodes around the individual organs, lymph node clusters, and, finally, into one of the large lymphatic trunks, which merge at the cisterna chyli to form the thoracic duct.

Lymph node clusters of the abdominal cavity [9][33]

They lie along the course of major blood vessels and are divided into three main groups: preaortic nodes, paraaortic nodes, and iliac lymph nodes. For more information on the lymphatic drainage of these lymph nodes, see “Abdominal lymph nodes.”

Lymphatic drainage of the abdominal cavity
Lymph nodes Location Area of drainage Termination
Preaortic lymph nodes
Paraaortic lymph nodes (lumbar nodes)
Iliac lymph nodes Common iliac lymph nodes
  • Around common iliac vessels
Internal iliac lymph nodes
  • Around internal iliac vessels
External iliac lymph nodes
  • Around external iliac vessels

Lymphatic trunks [9]

The three major lymphatic trunks drain into the cisterna chyli.

Cisterna chyli [9]

Clinical significance

Nerves of the abdominal cavitytoggle arrow icon

The visceral organs are innervated by sympathetic nervous system, parasympathetic nervous system, and enteric nervous system.

Sympathetic innervation [9][33]

Sympathetic innervation of abdominal organs [9]
Nerve Origin Course Site of synapse
Greater splanchnic nerve
Lesser splanchnic nerve
Least splanchnic nerve
Lumbar splanchnic nerves
Sacral splanchnic nerves

Parasympathetic innervation [9][33]

Parasympathetic innervation of abdominal organs [9]
Nerve Origin Course Site of synapse Area of innervation
Vagus nerve
Pelvic splanchnic nerves

The Cannon point (at the left colic flexure) is where parasympathetic innervation transitions from the vagus nerve to the pelvic splanchnic nerves.

The left vagus nerve is anterior to the stomach, and the right vagus is posterior to it. This can be remembered with the mnemonic LARP: Left Anterior, Right Posterior.

Prevertebral ganglia and autonomic nerve plexus [9]

Prevertebral plexus and ganglia of the abdominal cavity
Name of ganglia/plexus Location Afferent fibers Efferent fibers Area of innervation
Celiac plexus Celiac ganglion (paired)

Superior mesenteric ganglion and superior mesenteric plexus

  • Direct fibers
Aorticorenal ganglion (paired)
Aortic plexus [41] Intermesenteric plexus
Inferior mesenteric plexus and inferior mesenteric ganglion
  • Direct fibers
Superior hypogastric plexus
Inferior hypogastric plexus (pelvic plexus)
  • Direct fibers

Clinical significance

Referencestoggle arrow icon

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