EVALUATION OF OPERATIVE VERSUS CONSERVATIVE MANAGEMENT OF ADHESIONAL INTESTINAL OBSTRUCTION IN ASSIUT UNIVERSITY HOSPITAL (Retrospective study)

Abstract

ANATOMY OF PERITONEUM

Embryology of peritoneum:

The peritoneum develop from the primitive coelom, which is formed by a splitting of the lateral mesoderm into somatic and splanchnic layers. Originally, there are two bilateral cavities separated by the developing gastrointestinal tract, the somatic mesoderm lines the body wall portion of the coelom, and the splanchnic mesoderm covers the intestine. As the embryonic body wall closes ventrally, the two coelomic cavities fuse together in the midline. In between, the developing gut is covered on both sides by the splanchnic mesoderm. That portion of this double layer of mesoderm from which the gut is suspended is called the mesentery. As the ventral mesentry of the intestine is reabsorped, the two coelomic cavities join to become one (Rohr and McDonald, 1986).

Mesenteries and Omenta:

Embryology:

As the peritoneal cavity develops, the splanchnic mesoderm covers the developing gut. Eventually, most of the ventral mesentery resorbs except for that portion between the liver and the stomach which persists as the gastrohepatic (lesser) omentum. The dorsal mesentery remains intact but changes markedly in size and position as the gastrointestinal tract elongates and rotates. In the gastric region, the cardia of the stomach rotates to the left and the pylorus moves to the right. The dorsal mesogastrium grows with these changes but does so more than is necessary