STRUCTURE OF THE PERITONEUM AND ITS RELATIONSHIP WITH ABDOMINAL ORGANS: SURGICAL IMPORTANCE OF SINUSES, RECESSES, AND POUCHES
Abstract
The peritoneum is the largest serous membrane of the body, lining the abdominal cavity and covering most abdominal organs. It consists of parietal and visceral layers with a small amount of peritoneal fluid that reduces friction, supports immune defense, and helps distribute infection, inflammation, and fluid within the abdomen. Anatomically, the peritoneal cavity is a complex system formed by folds, mesenteries, and reflections, creating important structures such as sinuses, recesses, and pouches. These spaces control the movement of fluid and determine where pathological processes tend to localize. Clinically, the peritoneum is highly significant in conditions such as peritonitis, appendiceal perforation, intra-abdominal abscesses, and postoperative complications. Epidemiological data show that diffuse peritonitis is associated with high mortality, especially when diagnosis and treatment are delayed. Fluid commonly accumulates in dependent areas like the Douglas pouch, subphrenic spaces, and paracolic gutters, which are important in imaging and surgical drainage. A clear understanding of peritoneal anatomy improves diagnostic accuracy and surgical outcomes in abdominal diseases.