ArticlesAnatomyAbdomenPeritoneumOmental bursa

ArticlesAnatomyAbdomenPeritoneumOmental bursa

Omental bursa

Author: Alexandra Sieroslawska, MD • Reviewer: Dimitrios Mytilinaios, MD, PhD
Last reviewed: October 30, 2023
Reading time: 6 minutes

The omental bursa or lesser sac is a hollow space that is formed by the greater and lesser omentum and its adjacent organs. It communicates with the greater sac via the epiploic foramen of winslow, which is known as the general cavity of the abdomen that sits within the peritoneum, but outside the lesser sac.

This space has well-defined borders which are represented by certain organs or their parts, so they are quite easy to spot and form a mental image of the omental bursa. In addition, like anything in anatomy, the omental bursa doesn't just exist as a standalone and isolated entity, but rather it communicates with several other spaces and recesses found throughout the body.

Key facts about the omental bursa
Borders	Anteriorly - caudate lobe of liver, posterior gastrocolic ligament, lesser omentum Left - left kidney, left adrenal gland Posteriorly - pancreas Right - epiploic foramen, lesser omentum, greater sac
Communications	Superior recess, splenic recess, inferior recess, folds and recesses around the cecum and duodeum
Clinical	Congenital anomalies, hematomas, bilomas, abscess, pancreatitis, neoplasms, hydatid cyst, tuberculosis infection, mechanical irritation

This article will clarify all of the above, including the borders, communications, and embryology together with some additional clinical information to make the topic more tangible.

Contents

Borders
Communications and connections
Embryology
Clinical aspects
Sources

+ Show all

Borders

The borders of the omental bursa are demarcated as follows:

superiorly by the caudate lobe of the liver;
anteriorly by the hepatogastric ligament, posterior surface of the stomach, gastrocolic ligament and lesser omentum;
to the left, it is limited by the gastrosplenic and splenorenal ligaments, peritoneum of the left kidney and left suprarenal gland;
posteriorly it is walled off by peritoneum of the diaphragm, pancreas and duodenum;
to the right, the omental (epiploic foramen) and lesser omentum can be found and the greater sac beyond that;
inferiorly, it is limited by the transverse mesocolon.

Communications and connections

The cavity itself is almost completely closed, except for its communication with the greater sac and the entrance through the omental foramen and is filled with a capillary film. The greater part of the omental bursa consists of its superior recess which extends cranially between the diaphragm and the posterior layers of the coronary ligament of the liver.

The splenic recess extends to the left between the splenic ligaments and the stomach. Finally, the inferior recess of the omental bursa extends caudally between the stomach and the transverse colon. Other anatomical landmarks of note include a varied number of small peritoneal folds, recesses and fossae which seem to accumulate mostly around the cecum and the duodenum.

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If you are curious to discover more about the anatomy of the omental bursa, take a look below:

Embryology

During embryonic development, the peritoneum is anchored to the gut in the midline of the abdomen anteriorly, with the dorsal mesentery securing it posteriorly. The mesenteric layers develop in an anterior direction around the upper alimentary canal, carrying the blood supply and creating the ventral mesentery.

Due to the growth of the organs, they gradually become larger and have to shift in order to fit into the abdominal cavity. The stomach rotates 90 degrees, the spleen is displaced to the left and the liver moves to the right. The peritoneum twists with these movements which lead to the formation of the falciform ligament, the lesser omentum and the coronary ligaments of the liver . Throughout this entire process, the cavity of the lesser sac is created.

Omental bursa in a cadaver: Omental bursa is located posterior to the stomach. Therefore, it's very easy to find it during a cadaveric dissection by simply lifting the stomach. It communicates with the greater peritoneal sac via the omental foramen.

Test your knowledge on the omental bursa with this quiz.

Clinical aspects

The lesser sac has seven distinctly categorized pathological groups under which its potential disorders may be listed:

Congenital anomalies include duplication cysts and cystic lymphangiomas.
A hematoma or a biloma are classed as traumatic injuries.
Inflammatory states could be due to an abscess, a pseudocyst or even acute pancreatitis.
Neoplastic changes may lead to the growth of a stromal tumor, a leiomyoblastoma, a leiomyosarcoma, a liposarcoma, a schwannoma, both benign and malignant pancreatic neoplasms that may have endocrine involvement or not, hepatic tumors and desmoid tumors.
A hydatid cyst indicates a parasitic infestation.
The only infective cause of a lesser sac disorder as yet known of is tuberculosis.
Mechanical irritation could potentially be caused by hernias of the cecum, transverse colon, small intestine and gallbladder.

Sources

All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

References:

Helga Fritsch & Wolfgang Kuehnel: Color Atlas of Human Anatomy, Volume 2 Internal Organs, 5th Edition, Thieme, Alimentary System: Pancreas, Topography of Omental Bursa and Pancreas, Page 222 to 223.
Frank H. Netter, MD: Atlas of Human Anatomy, Fifth Edition, Saunders - Elsevier, Chapter Abdomen, Subchapter 26 Peritoneal Cavity, Guide: Peritoneum, Page 138 to 140.

Illustrators:

Overview of the omental bursa and neighbouring structures (ventral view) - Esther Gollan
Omental bursa in a cadaver - Prof. Carlos Suárez-Quian

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