胃裸区的解剖观测及其临床意义

Anatomical Study of Bare Area of Stomach and Its Clinical Significance

目的:查明胃裸区的形态学特征,为上腹部影像学诊断和外科治疗提供形态学依据。方法:正常成人尸体36具(男30、女6),解剖显露胃裸区周界腹膜返折形成的韧带并测量其边长,以此确定胃裸区的位置、形态并计算其面积;按断层标准制作的横、矢、冠状标本各2套,对胃裸区出现的平面及在该平面的长度、宽度和胃裸区与左侧膈肌之间的结构进行观察。结果:①胃裸区位于内、外侧胃膈韧带和胃胰韧带之间,近似于梯形,面积为(9.47±7.08)cm2;②胃裸区后腹膜外间隙与左肾周间隙和胰周间隙相交通,其内有血管、淋巴结、左肾上腺、左肾上极和胰上缘等结构。结论:胃裸区的出现率为100%,胃裸区以及胃裸区后腹膜外间隙内所含的结构在急性胰腺炎病例可能被累及;认识胃裸区的形态学特征具有一定的影像诊断学价值和外科手术意义。

Objective： To Investigate the morphological features of the bare area of stomach to provide morphology data for the modern imaging diagnosis and surgical treatment of the upper part of abdomen. Methods： The position, shape and area of the bare area of the stomach （BAS） and structures within BAS were investigated using 36 Chinese adult cadavers by gross dissection. The plane of BAS was discovered and its length, width and the structures between BAS and the left diaphragm were observed in the specimen according the sectional required. Results： （1）BAS was located between the medial gastrophrenie ligament, lateral gastrophrenic ligament and the gastropancreatic ligament. The shape was like trapezium mostly, the area was about 9.47±7.08 cm^2. （2） The space of the extraperitoneal behind BAS was communicated with the left pararenal space and the parapancreatic space. The left suprarenal gland, the superior pole of the left kidney and the superior part of the pancreatic body were also extended into BAS besides the posterior vagal trunk, vessels and lymph nodes. Conclusion： The existing rate of BAS was 100%. The stomach should be regard as interperitoneal viscera. BAS and the structures within the extraperitoneal space posterior to the bare area of the stomach may be involved in the cases of acute pancreatitis. Understanding the morphological features of BAS had a great significance for the modern imaging diagnosis and surgical treatment.