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Ligamentum Phrenicocolicum – Anatomy and Function

The ligamentum phrenicocolicum is a peritoneal fold connecting the diaphragm to the left colic flexure, supporting the spleen from below.

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Things worth knowing about "Ligamentum phrenicocolicum"

The ligamentum phrenicocolicum is a peritoneal fold connecting the diaphragm to the left colic flexure, supporting the spleen from below.

Definition

The ligamentum phrenicocolicum (also written as lig. phrenicocolicum) is a fold of peritoneum (the membrane lining the abdominal cavity) that connects the diaphragm to the left colic flexure, also known as the splenic flexure of the colon. It is an anatomical structure of the upper abdomen with an important mechanical support function.

Anatomy and Location

The ligamentum phrenicocolicum is situated in the left upper abdomen. It extends between the inferior surface of the diaphragm and the upper portion of the descending colon at the level of the left colic flexure. The structure forms a sling-like support on which the spleen (splen) rests from below. For this reason, the ligamentum phrenicocolicum is sometimes referred to as the sustentaculum lienis, meaning the supporter or shelf of the spleen.

Relationship to the Spleen

The spleen is located in the left upper quadrant of the abdomen and is held in position by several ligaments and peritoneal attachments. The ligamentum phrenicocolicum forms the lower boundary of the so-called splenic recess (a niche in the left upper abdomen), preventing the spleen from descending into the abdominal cavity and thus contributing to the stable position of the organ.

Clinical Relevance

Although the ligamentum phrenicocolicum is a relatively small anatomical structure, it is clinically significant in several contexts:

Splenic surgery: During surgical procedures involving the spleen, such as a splenectomy (surgical removal of the spleen), the ligamentum phrenicocolicum must be divided. Knowledge of its exact position is essential to avoid inadvertent injury to the diaphragm or the colon.
Colonic surgery: During operations on the left colic flexure or descending colon, for example in tumor resections or procedures for inflammatory bowel disease, mobilization of the ligamentum phrenicocolicum is an important surgical step.
Laparoscopic procedures: In minimally invasive (laparoscopic) operations in the left upper abdomen, the ligament is carefully identified and divided as needed to gain access to the splenic flexure or the spleen.
Diagnostic imaging: In computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen, the ligamentum phrenicocolicum can be identified as an anatomical landmark.

Embryology

From a developmental perspective, the ligamentum phrenicocolicum, like other peritoneal structures, is derived from the mesoderm during embryonic development. The rotation of the midgut during fetal development leads to the formation of various peritoneal folds and mesenteries, including the ligamentum phrenicocolicum.

Summary

The ligamentum phrenicocolicum is an anatomically relevant peritoneal fold in the left upper abdomen. It connects the diaphragm to the left colic flexure, supports the spleen inferiorly, and plays a practical role in various abdominal surgical procedures.

References

Standring, S. (Ed.) (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice. 42nd edition. Elsevier.
Drake, R.L., Vogl, A.W. & Mitchell, A.W.M. (2019). Gray's Atlas of Anatomy. 3rd edition. Elsevier.
Moore, K.L., Dalley, A.F. & Agur, A.M.R. (2018). Clinically Oriented Anatomy. 8th edition. Wolters Kluwer.

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