Book 4 - Self Instructional Manual for Cancer Registrars - SEER ...

The medial border of the stomach is called the lesser curvature, and the lateral border is calledthe greater curvature. These designations are important in pinpointing the location of neoplasms.A large fold of peritoneum called the greater omentum, or gastrocolic omentum, extends downfrom the anterior surface of the stomach connecting the abdominal viscera. It contains fat cells,blood and lymphatic vessels, and nerves. A similar fold called the lesser omentum, or gastrohepaticomentum, extends between the liver and the lesser curvature of the stomach.The mucosa (described earlier) is composed of three layers: the surface epithelium, the laminapropria, and the muscularis mucosae. This middle layer (lamina propria) is thick and filled withglands which secrete both mucous and enzymes. When the stomach is empty, the mucosa forms foldscalled rugae 1. The submucosa is composed of dense connective tissue with large blood and lymphvessels. The muscularis propria is composed of three muscular layers as compared to two in theesophagus. These are called the longitudinal, circular, and oblique layers. This muscular wall servesas a churn to help break up and mix food with the gastric juices. A serosa of visceral peritoneuminvests the outer surface of the stomach.The blood supply to the stomach is derived from branches of the celiac artery. The venousdrainage is into the portal vein, either directly or by way of the splenic and superior mesenteric veins.The regional lymph nodes are as follows:Inferior (right) gastric: Splenic:Greater curvature Gastroepiploic, leftGreater omental PancreaticolienalGastroduodenalPeripancreaticGastrocolic Splenic hilarGastroepiploic, rightGastrohepaticPyloric, incl. sub-/infrapyloricPancreaticoduodenal (Anteriorly along first part of the duodenal)Superior (left) gastric:Lesser curvatureLesser omentalGastropancreatic, leftGastric, leftParacardial; cardialCardioesophagealCeliacHepatic(excl. gastrohepatic)lrugae--ridges, wrinkles, or folds, as of mucous membrane.210