Lesser sac

 

The Lesser Sac (Omental Bursa)

The lesser sac is an extensive, irregular peritoneal pouch located posterior to the stomach and the lesser omentum. It allows the stomach to move freely against the structures of the posterior abdominal wall.

Anatomical Boundaries

  • Anterior: Posterior wall of the stomach and the lesser omentum.
  • Posterior: Pancreas, left kidney, left adrenal gland, and the diaphragm.
  • Superior: Liver (caudate lobe).
  • Inferior: Transverse mesocolon.

Communication: The Epiploic Foramen

The lesser sac communicates with the greater sac via the Epiploic Foramen (Foramen of Winslow).

Direction Boundary of Epiploic Foramen
Anterior Hepatoduodenal ligament (containing the portal triad).
Posterior Inferior Vena Cava (IVC).
Superior Caudate lobe of the liver.
Inferior First part of the duodenum.

High-Yield Exam Pearl:

Because the portal triad (common bile duct, hepatic artery, and portal vein) lies anterior to the epiploic foramen, an actively bleeding vessel in this region can be controlled by inserting a finger into the foramen and clamping the hepatoduodenal ligament (the Pringle Maneuver).