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Topographic Anatomy · Topographic Anatomy of the Abdomen

Ligamentous apparatus of the stomach

The ligamentous apparatus of the stomach consists of peritoneal folds that connect the organ to adjacent structures: the liver, spleen, diaphragm, and colon. Knowledge of the composition and topography of these ligaments is of fundamental importance in abdominal surgery, as key arteries, veins, and nerve trunks run within their thickness.

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Greater omentumThe gastrocolic ligament forms the upper part of the greater omentum
Surgical accessThe loose attachment to the mesentery allows for bloodless separation of the greater curvature during oncological resection
Low-vascular zoneThe gastrophrenic ligament is poorly vascularized and does not require ligation
Treitz's muscleOriginates in the circular layer of the duodenum and weaves into the left crus of the diaphragm
4 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Ligaments of the greater curvature and fundus of the stomach

The ligamentous apparatus in the region of the greater curvature and fundus of the stomach includes the following peritoneal folds:

  • Gastrocolic ligament (lig. gastrocolicum) is formed by the transition of two layers of visceral peritoneum from the greater curvature of the stomach to the transverse colon. It constitutes the upper part of the greater omentum (omentum majus). Because the ligament is connected rather loosely to the transverse mesocolon, during surgical treatment of gastric cancer, the greater curvature can be separated along with the omentum in a bloodless manner. Within the thickness of the ligament, running parallel to the arch of the greater curvature toward each other and anastomosing, are the right gastro-epiploic artery (a. gastroepiploica dextra) and the left gastro-epiploic artery (a. gastroepiploica sinistra).
  • Gastrosplenic ligament (lig. gastrolienale) extends from the upper segment of the greater curvature to the hilum of the spleen, covering its vascular pedicle. It contains the short gastric arteries and veins (aa. et vv. gastricae breves).
  • Gastrophrenic ligament (lig. gastrophrenicum) is formed by the transition of the parietal peritoneum from the diaphragm to the anterior surface of the fundus and partially the cardiac region. It has a very sparse vascular bed, and therefore it is transected without prior ligation during organ mobilization.
Free video tutorialUpper floor of the abdominal cavity: topography of spaces, ligaments, and omental foramen

Ligaments of the lesser omentum and cardia

The lesser omentum and the cardiac region are fixed by structures connecting the stomach to the liver and diaphragm:

  • Hepatogastric ligament (lig. hepatogastricum) extends from the porta hepatis to the lesser curvature of the stomach as two peritoneal layers. It is trapezoidal in shape, with its wide base fixed to the lesser curvature.
  • Phrenicoesophageal ligament (lig. phrenicoesophageum) appears at the transition zone of the parietal peritoneal layer from the diaphragm to the cardia and esophagus. In the loose adipose tissue at its base run the anterior vagal trunk (truncus vagalis anterior) and the esophageal branch of the left gastric artery (a. gastrica sinistra).
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Associated ligaments of the duodenum

Ligamentous structures directly adjacent to the gastroduodenal junction and fixing the duodenum:

  1. Hepatoduodenal ligament (lig. hepatoduodenale) is stretched between the porta hepatis and the superior wall of the duodenal bulb (bulbus duodeni). It serves as the rightmost part of the lesser omentum and bounds the epiploic foramen anteriorly.
  2. Duodenorenal ligament (lig. duodenorenale) is a wide peritoneal fold (parietal layer of the posterior abdominal wall) stretched between the right margin of the descending part of the duodenum and the right kidney. It bounds the epiploic foramen inferiorly.
  3. Suspensory muscle of duodenum (Treitz's ligament) (lig. suspensorium duodeni) supports the duodenojejunal flexure (flexura duodenojejunalis). It is a peritoneal fold containing the muscle that suspends the duodenum (m. suspensorius duodeni). This muscle originates from the circular smooth muscle bundles of the intestine in the region of the flexure, ascends posterior to the pancreas, and fans out into the muscle fibers and fascia of the left crus of the diaphragm.

Briefly: answers to topical questions

What anatomical structures run within the thickness of the hepatoduodenal ligament?

The elements of the portal triad, additional blood vessels, lymph nodes, and nerve plexuses run within the thickness of the hepatoduodenal ligament.

  • Proper hepatic artery (a. hepatica propria) and its branches are located on the left.
  • Bile duct (ductus choledochus), as well as the common hepatic and cystic ducts, are located on the right.
  • Portal vein (v. portae) is located between them and posteriorly.
  • Right gastric vessels (a. et v. gastricae dextrae) and gastroduodenal vessels (a. et v. gastroduodenales) run in the inferior section.
  • Hepatic plexus (plexus hepaticus) includes the anterior and posterior plexuses.

The ligament also contains lymph nodes and vessels.

Which anatomical structures bound the epiploic foramen superiorly and posteriorly?

The epiploic foramen is bounded superiorly by the caudate lobe of the liver, and posteriorly by the parietal peritoneum and ligament.

  • Caudate lobe of the liver serves as the upper boundary of the foramen.
  • Parietal peritoneum covers the inferior vena cava (v. cava inferior) and forms the posterior wall.
  • Hepatorenal ligament (lig. hepatorenale) also participates in forming the posterior boundary.

Which ligaments form the lesser omentum?

The lesser omentum is formed by two main peritoneal ligaments.

  • Hepatogastric ligament (lig. hepatogastricum) connects the inferior surface of the liver to the lesser curvature of the stomach.
  • Hepatoduodenal ligament (lig. hepatoduodenale) occupies the rightmost position within the lesser omentum, located between the porta hepatis and the superior wall of the duodenal bulb.
How to memorize

To memorize the boundaries of the epiploic foramen: anteriorly it is closed by the hepatoduodenal ligament (lig. hepatoduodenale), and inferiorly by the duodenorenal ligament (lig. duodenorenale).

Class and exam questions

In which ligament does the anterior vagal trunk run?

The anterior vagal trunk (truncus vagalis anterior) runs in the loose tissue at the base of the phrenicoesophageal ligament (lig. phrenicoesophageum) along with the esophageal branch of the left gastric artery.

Which arteries anastomose in the gastrocolic ligament?

In the gastrocolic ligament (lig. gastrocolicum) along the greater curvature, the right and left gastro-epiploic arteries run toward each other and anastomose (a. gastroepiploica dextra et sinistra).

What are the anterior and inferior anatomical boundaries of the epiploic foramen?

Anteriorly, the epiploic foramen is bounded by the hepatoduodenal ligament (lig. hepatoduodenale), and inferiorly by the duodenorenal ligament (lig. duodenorenale).

Where does Treitz's muscle originate and where does it insert?

Treitz's muscle (m. suspensorius duodeni) originates from the circular muscle layer of the duodenojejunal flexure, ascends posterior to the pancreas, and fans out into the fascia and bundles of the left crus of the diaphragm.

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What else to study on this topic

  • Surgical anatomy of the lesser and greater omenta
  • Topography of vessels and nerves of the phrenicoesophageal junction
  • Technique of mobilizing the greater curvature of the stomach during oncological surgeries
  • Anatomical landmarks and boundaries of the epiploic foramen
  • Structure and topographic relationships of Treitz's muscle and ligament

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Other topics in the section "Topographic Anatomy of the Abdomen"

Topographic Anatomy of the AbdomenProjection of organs onto the abdominal wallTopographic anatomy of the anterolateral abdominal wallExternal oblique abdominal muscleInternal oblique abdominal muscleRectus abdominis muscleEndoabdominal fascia and extraperitoneal adipose tissueRelief of the posterior surface of the anterior abdominal wallBlood supply to the anterolateral abdominal wallLymphatic system and innervation of the anterior abdominal wallLinea albaTopographic anatomy of the umbilical regionTopography of the abdominal cavity organsInguinal canalInguinal trianglePeritoneal cavitySupramesocolic compartmentTopographic anatomy of the liverBlood supply and innervation of the liverTopographic anatomy of the portal veinTopographic anatomy of the gallbladderTopographic anatomy of the extrahepatic biliary ductsAbdominal part of the esophagusTopographic anatomy of the stomach
The entire section "Topographic Anatomy of the Abdomen"

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