ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2022, 7(2): 74–81
https://doi.org/10.26693/jmbs07.02.074
Experimental Medicine

Anatomy of the Greater Omentum in Elderly People

Fedorchenko I. L., Stepanchuk A. P.
Abstract

The purpose of the study was to investigate the external structure, topographic and morphometric variability of the arteries of the greater omenta in elderly women and men in normal cases. Materials and methods. The greater omenta of elderly women and men were examined using anatomical preparation, somatoscopic and morphometric methods. Greater omenta were examined on 20 corpses of elderly people. The deceased had no pathology in the abdominal cavity. Based on the value of the body mass index, the body type of people was determined. Results and discussion. The greater omentum is supplied by the right and left gastroepiploic arteries. These arteries form the superior arterial arch in 15 of 18 cases, and in 3 cases the arch was absent. The inferior arterial arch was evident in 1 of 20 cases. The left gastroepiploic artery in 2 of 20 cases was absent on the anterior plate of the greater omentum and was detected in the thickness of the posterior plate of the greater omentum. From the right gastroepiploic artery central, right medial, right intermediate and right lateral arteries depart. In two out of 20 cases, the left accessory artery departed from the right gastroepiploic artery, which was located in the left half of the greater omentum. The central artery of the greater omentum has a greater length and outer diameter in men. The branches of the right gastroepiploic artery supply the right half of the greater omentum and reach the lower edge of its free part. The left gastroepiploic artery branches into the left medial, left intermediate and left lateral arteries, which branch in the thickness of the left half of the omentum, supplying it without reaching the lower edge of its free part. In 45% quadrangular, 15% – triangular and 40% – irregular shape of the greater omentum with two or more lobes were revealed. The zone of the central, and in its absence, the right medial and left medial arteries of the greater omentum is most convenient for excision of the flap for transplantation with quadrangular and triangular forms of the greater omentum in the elderly. Conclusion. In elderly people, the shape of the greater omentum does not depend on their body type. The quadrangular omenta have the largest area, the smaller triangular and irregular ones. The presence of adipose tissue in the greater omentum depends on body weight. It is advisable to perform laparoscopy before omentoplasty in a patient with excessive body weight. With age, the appearance of the greater omentum changes due to the presence of adipose tissue. We have identified the following forms of the greater omentum, depending on the presence of the severity of adipose tissue: it was transparent, like fine lace; large omentum with excessively developed adipose tissue covering the omentum with a continuous layer

Keywords: shape, arteries of the greater omentum, morphometry

Full text: PDF (Ukr) 376K

References
  1. Khalikova LV. Bolshoy salnik u bolnykh rakom yaichnikov [Greater omentum in patients with ovarian cancer]. Kreativnaya khirurgiya i onkologiya. 2013;4(5):80-83. [Russian]
  2. Makurina ON. Sosudistyye konstruktsii i immunnyye struktury bolshogo salnika cheloveka [Vascular structures and immune structures of the human greater omentum]. Vestnik SamGU. 2001;22(4):199-208. [Russian]
  3. Wilkosz S, Ireland G, Khwaja N, Walker M, Butt R, Miller A, et al. A comparative study of the structure of human and murine greater omentum. Anat Embryol (Berl). 2005 Feb;209(3):251-261. PMID: 15662530. https://doi.org/10.1007/s00429-004-0446-6
  4. Rangel-Moreno J, Moyron Qiroz JE, Cfrrzgher DM, Kusser K, Hartson L, Randall TD. Omental milki spots develop in the absence of lymphoid tissue-inducer cells and support B and T cell responses to peritoneal antigens. Immunity. 2009 May;30(5):731-743. PMID: 19427241. PMCID: PMC2754314. https://doi.org/10.1016/j.immuni.2009.03.014
  5. Shkvarkovskiy IS. Topografoanatomicheskoye obosnovaniye omentopankreatoplastiki [Topographer Anatomical substantiation of omento pancreatitis plastics]. Klinicheskaya khirurgiya. 2004;(6):4-45. [Ukrainian]
  6. Ovsyannikov AV. Obosnovaniye novykh tekhnologiy rekonstruktivno-vosstanovitel'noy mammoplastiki [Substantiation of new technologies of reconstructive and restorative mammoplasty]. Abstr. Dr. Sci. (Med.). Volgograd; 2009. 38 s. [Russian]
  7. Shevlyuk NN, Khalikova LV, Khalikov AA. Morfofunktsional'naya kharakteristika bolshogo salnyka [Morphofunctional characteristics of the greater omentum]. Zhurnal anatomii i gistologii. 2020;9(2):90-99. [Russian]. https://doi.org/10.18499/2225-7357-2020-9-2-90-99
  8. Feodosiadi LA. Morfologicheskaya obyektivizatsiya pokazaniy k sanatsionnym relaparotomiyam v kompleksnom lechenii razlitogo gnoynogo peritonita [Morphological objectification of indications for sanation relaparotomy in the complex treatment of diffuse purulent peritonitis]. Abstr. PhDr. (Med.). M; 2004. 24 s. [Russian]
  9. Gataulin NG, Gantsev ShKh, Khunafin SN. Diagnostika i lecheniye zabolevaniy bolshogo salnyka [Diagnosis and treatment of diseases of the greater omentum]. Ufa: Bashkirskoye knizhnoye izdaniye; 1988. 96 s. [Russian]
  10. Nekrutov AV, Karaseva OV, Rashal' LM. Bolshoy salnik: morfofunktsional'nyye osobennosti i klinicheskoye znacheniye v pediatrii [Greater omentum: morphofunctional features and clinical significance in pediatrics]. Voprosy sovremennoy pediatrii. 2007;6(6):58-63. [Russian]
  11. Maksimenkov AN. Khirurgicheskaya anatomiya zhivota [Surgical anatomy of the abdomen]. L: Kniga; 1972. 688 s. [Russian]
  12. Libermann-Meffert D, Uayt KH. Bolshoy salnik [Greater omentum]. M: Meditsina, 1989. 336 s. [Russian]
  13. Fedorchenko IL, Stepanchuk AP. Zovnishnya budova velykoho cheptsya ludyny v vikovomy aspekti [Age-related external structure of human greather omentum]. Aktualni problemy suchasnoi medytsyny: Visnyk Ukrainskoi medychnoi stomatologichnoi akademii. 2020;20(3):222-8. [Ukrainian]. https://doi.org/10.31718/2077-1096.20.3.222
  14. Nikonenko AS, Gubka AV, Pertsov VI, Osaulenko VV, Yermalayev YeV. Ispolzovaniye bolshogo salnika v revaskulyarizatsii ishemizirovannykh organov [The use of the greater omentum in the revascularization of ischemic organs]. Klíníchna khírurgíya. 2000;4:9-11. [Russian]
  15. Guseynov TS, Guseynova ST, Suleymanova RG, Atayeva DA, Khalilov MA. Osobennosti anatomii bolshogo salnyka [Features of the anatomy of the greater omentum]. Vestnik novykh meditsinskikh tekhnologiy. 2018;(6):16-8. [Russian]
  16. Khodov NA. Klinicheskaya anatomiya bolshogo salnyka [Clinical anatomy of the greater omentum]. Molodyi vchenyy. 2018;(51):76-80. [Russian]
  17. Settembre N, Labrousse M, Magnan PE, Branchereau A, Champsaur P, Bussani R, et al. Surgical anatomy of the right gastro- omental artery: a study on 100 cadaver dissections. Surg Radiol Anat. 2018 Apr;40(4):415-422. PMID: 29209990. https://doi.org/10.1007/s00276-017-1951-7
  18. Suma H. Gastroepiploic artery graft in coronary artery bypass grafting. Ann Cardiothorac Surg. 2013 Jul;2(4):493-498. PMCID: PMC3844632. doi.org/10.1186/1749-8090-8-S1-O181
  19. O'Malley J, Bordoni B. Anatomy, Abdomen and Pelvis, Stomach Gastroepiploic Artery. In: Stat Pearls. [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545306