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Mesogastrium – Anatomy and Clinical Relevance

The mesogastrium is an embryonic peritoneal fold that suspends the stomach and guides its positional development within the body during fetal growth.

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Things worth knowing about "Mesogastrium"

The mesogastrium is an embryonic peritoneal fold that suspends the stomach and guides its positional development within the body during fetal growth.

What is the Mesogastrium?

The mesogastrium is a double-layered fold of the peritoneum (the membrane lining the abdominal cavity) that attaches the stomach to the abdominal wall and suspends it within the abdominal cavity. The term derives from the Greek words mesos (middle) and gaster (stomach). The mesogastrium plays a central role primarily in embryology – the study of the development of the unborn child – as it is significantly involved in the positioning and rotation of the stomach during fetal development.

Anatomical Structure

Anatomically, two sections of the mesogastrium are distinguished:

Ventral mesogastrium (anterior mesogastrium): Connects the stomach to the anterior abdominal wall and the liver. From this section, the lesser omentum (omentum minus) and the falciform ligament of the liver develop.
Dorsal mesogastrium (posterior mesogastrium): Connects the stomach to the posterior abdominal wall. From it arise the greater omentum (omentum majus), the spleen, and parts of the pancreas.

Development in Embryology

In early embryonic development, the stomach is attached to both the dorsal and ventral body walls via the mesogastrium. During the process of gastric rotation – a physiological rotation of the stomach around its longitudinal axis in the second month of pregnancy – the mesogastrium is simultaneously rotated and reshaped. This gives rise to the omental bursa (bursa omentalis), an enclosed space behind the stomach that can be clinically relevant, for example in cases of abscesses or pancreatic cysts.

Clinical Relevance

Although the term mesogastrium is used primarily in anatomy and embryology, it also has clinical significance:

Congenital malformations: Disruptions in the rotation of the mesogastrium can lead to congenital positional anomalies of the stomach or surrounding organs.
Omental bursa: Pathological processes such as fluid collections, abscesses, or pancreatic pseudocysts can develop within this space formed from the mesogastrium.
Surgical orientation: During upper abdominal surgery, structures derived from the mesogastrium – such as the greater and lesser omentum – serve as important anatomical landmarks.

Distinction from Similar Terms

The mesogastrium should not be confused with the mesentery, which suspends the small intestine, or the mesocolon, which attaches the large intestine. However, all of these structures are related peritoneal folds and belong to the group of mesenteries in the broader sense.

References

Moore, K. L., Persaud, T. V. N. & Torchia, M. G. - The Developing Human: Clinically Oriented Embryology. 10th edition. Elsevier, 2016.
Standring, S. (ed.) - Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st edition. Elsevier, 2015.
Sadler, T. W. - Langman's Medical Embryology. 14th edition. Wolters Kluwer, 2019.

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