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ID:32445136
大小:4.66 MB
页数:45页
时间:2019-02-04
《Chapter 49 – Stomach》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、CHAPTER49STOMACHDavidM.MahviandSethB.Krantzdiaphragmaticesophagealhiatusinthehorizontalplaneoftheanatomyseventhchondrosternalarticulation,aplaneonlyslightlycepha-physiologyladtothatcontainingthepylorus.Thegastrosplenicligamentppepticulcerdiseaseattachestheproximalgreate
2、rcurvaturetothespleen.stressgastritispostgastrectomysyndromesBloodSupplygastriccancerTheceliacarteryprovidesmostofthebloodsupplytotheothergastriclesionsstomach(Fig.49-2).Therearefourmainarteries—theleftandrightgastricarteriesalongthelessercurvatureandtheleftandrightgast
3、roepiploicarteriesalongthegreatercurvature.Inaddi-tion,asubstantialquantityofbloodmaybesuppliedtotheANATOMYproximalstomachbytheinferiorphrenicarteriesandbytheshortgastricarteriesfromthespleen.ThelargestarterytoGrossAnatomythestomachistheleftgastricartery,anditisnotuncom
4、mon(15%to20%)foranaberrantlefthepaticarterytooriginateDivisionsfromit.Consequently,proximalligationoftheleftgastricarteryThestomachbeginsasadilationinthetubularembryonicoccasionallyresultsinacuteleft-sidedhepaticischemia.Theforegutduringthefifthweekofgestation.Bytheseve
5、nthweek,rightgastricarteryarisesfromthehepaticartery(orthegastro-itdescends,rotates,andfurtherdilateswithadisproportionateduodenalartery).Theleftgastroepiploicarteryoriginatesfromelongationofthegreatercurvatureintoitsnormalanatomicthesplenicarteryandtherightgastroepiplo
6、icoriginatesfromshapeandposition.Followingbirth,itisthemostproximalthegastroduodenalartery.Theextensiveanastomoticconnec-abdominalorganofthealimentarytract.Themostproximaltionbetweenthesemajorvesselsensuresthatinmostcases,theregionofthestomachiscalledthecardia,whichatta
7、chestothestomachwillsurviveifthreeoutoffourarteriesareligated,esophagus.Immediatelyproximaltothecardiaisaphysiologi-providedthatthearcadesalongthegreaterandlessercurvaturescallycompetentloweresophagealsphincter.Distally,thepylorusarenotdisturbed.Ingeneral,theveinsofthes
8、tomachparallelconnectsthedistalstomach(antrum)totheproximalduode-thearteries.Theleftgastric(coronary)andrightg
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