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Peritoneum and Peritoneal Folds The peritoneum is the largest serous membrane in the body and lines the abdominal cavity. The tissue has several components including the the mesothelium and an underlying supporting areolar connective tissue layer. The connective tissue in turn has two layers: the parietal peritoneum, which lines the abdominal wall, and the visceral peritoneum, which covers some organs and serves as their serosae. The peritoneal cavity is the small space between the parietal and visceral peritoneum that contains the lubricating serous fluid. The peritoneum includes large folds that bind organs to each other and to the abdominal walls. This keeps the organs in the proper place and suspends them when we are upright. Within these folds are blood vessels, lymphatic vessels, and nerves that innervate the abdominal organs. The Five Major Peritoneal Folds Fold Description Comment Greater omentum Drapes over the transverse colon and small intestine High adipose tissue content vastly expands with weight gain, creating the characteristic "beer belly" Falciform ligament Attaches the liver to the anterior abdominal wall and diaphragm The liver is the only digestive organ attached to the anterior abdominal wall Lesser omentum Suspends the stomach and duodenum from the liver Provides a pathway for the blood supply of liver; contains the common bile duct Mesentery Attaches the jejunum and ileum of the small intestine to the posterior abdominal wall Includes blood and lymphatic vessels, and lymph nodes Mesocolon Attaches the transverse colon and sigmoid colon of the large intestine to the posterior abdominal wall Along with mesentery, it holds intestines loosely in place, enabling movement with muscle contractions EXAMPLE Homeostatic Imbalances of the Peritoneum: Peritonitis Inflammation of the peritoneum is called peritonitis. It can be caused by an injury that penetrates into the abdomen or from an ulcer that perforates the stomach wall, allowing gastric fluids into the peritoneal cavity. The most common cause of peritonitis is a ruptured appendix. The appendix is a terminal part of the cecum (a peritoneal pouch at the beginning of the large intestine), and the function (if any) is still debated. When the appendix bursts open, bacteria-laden feces spurt into the peritoneum. Usually, the peritoneal layers will bind together around the site of inflammation, keeping the infection from spreading, while macrophages move in to dispose of infected tissue. Peritonitis that spreads out into the peritoneal cavity can be life threatening. Surgically removing the infected tissue and administering high doses of antibiotics treat the condition. Generally, peritonitis is a concern with any kind of puncture wound to the abdomen.