Морфологія великого чепця людини та клінічні аспекти

Abstract

В огляді розглянуті структурна організація і вікові особливості великого чепця людини, які визначають його унікальність і функціональне різноманіття в організмі людини. Обговорюються захисні властивості «молочних плям» великого чепця і його використання в реконструктивно-пластичній хірургії. Водночас проаналізовані методи дослідження та їх використання для виявлення рідких патологій чепця; В обзоре рассмотрены структурная организация и возрастные особенности большого сальника человека, которые определяют его уникальность и функциональное разнообразие в организме человека. Обсуждаются защитные свойства «молочных пятен» большого сальника и его использование в реконструктивно-пластической хирургии. В то же время проанализированы методы исследования и их использование для выявления редких патологий сальника; Abstract. The review examines the structural organization and age characteristics of the human greater omentum, which determine its uniqueness and functional diversity in the human body. The human greater omentum has a diverse shape, which is determined by its loose part. The omentum can be unilobar, bilobar and multilobar. The base of each lobe is usually below and rarely above the transverse colon, and their lower edges are rounded. Them, unilobar shape of the greater omentum is most often observed. The shape of the unilobar greater omentum may, be quadrangular or triangular, but the bilobar omentum is rare. The multilobar shape of the greater omentum is observed less rarely than the bilobar one. In 22 cases out of 97, the greater omentum was dissected into 3-6 lobes in the loose part and only in 1 case the dissection of fragments reached the greater curvature of the stomach. The article discusses the protective properties of «milky spots» of the greater omentum – the specialized formations, involved in specific immunological reactions and its use in the reconstructive and plastic surgery. It has been established that there are three types of «milky spots»: primary (found in the fetus, newborns and children under 5 years), passive (containing adipose cells) and active secondary. The «milky spots» of the greater omentum appear in the midst of prenatal development of the embryo and exist throughout the human life. They are found all over the greater omentum, both in the area of the gastrointestinal ligament (the fixed part of the greater omentum), and on the anterior and posterior plates of its loose part. The stroma of the «milky spots» is made up of mesothelial and reticular cells. Numerous macrophages, lymphocytes, adipocytes, plasma and mast cells have been identified as part of the «milky spots». Due to their cellular composition and stable structure, they are a source of emergency release of free macrophages and lymphocytes into the abdominal cavity with subsequent phagocytosis and antibodies formation. It has been found out that the greater omentum is a significant factor in the fight against infection in the abdominal cavity due to its mobility and ability to form a dividing shaft around the intra-abdominal inflammation, which is ensured by its active migration to the sites of infection. The development of connective tissue in the abdominal cavity during the formation of the connection process with the participation of the greater omentum should be considered in the dynamics of integration of pathological processes such as inflammation, proliferation and fibrosis. At the same time, the methods of study and their use for the detection of rare pathologies of the omentum have been analyzed.