Case

A patient comes to your practice complaining of a severe and constant burning pain in the upper left quadrant and symptoms of nausea, vomiting, and bloating. The patient has a history of stomach ulcers.  Upper GI endoscopy shows that the patient has a perforating ulcer in the posterior mid body of the stomach that is leaking gastric fluid out of the stomach.

Question 1/3 - Into which subdivision of the abdomen/pelvis are gastric juices leaking?

Click on your selected option(s) below  (correct = 1,  over-thinking = 2+)

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Incorrect. The stomach is an intraperitoneal structure, thus any leakage from the stomach will be into the peritoneal cavity. Only when an organ is retroperitoneal would leakage enter directly to the retroperitoneum.

Incorrect. The greater sack is the peritoneal cavity anterior and inferior to the stomach (i.e. everything of the peritoneal cavity that isn't posterior to the stomach is the greater sac).   

Correct! The region of the peritoneal cavity posterior to the stomach is the lesser sac. This is a cul-du-sac region of the peritoneal cavity with an entry through the epiploic foramen.

Incorrect. The perirenal space is the area of the retroperitoneum surrounding the kidney (i.e. 'peri' to the kidney). The stomach is an intraperitoneal structure, thus any leakage from the stomach will be into the peritoneal cavity. Only when an organ is retroperitoneal would leakage enter directly to the retroperitoneum.

Incorrect. The false pelvis is the region of the peritoneal cavity bounded by the bony ala (wings) of the pelvic iliac bone. Thus, the false pelvis is a regional subset of the greater sack located in the pelvis distant from the stomach.