Анатомія великого чепця у людей похилого віку

Abstract

The purpose of the study was to investigate the external structure, topographic and morphometric variability of the arteries of the greater omenta in elderly women and men in normal cases. Materials and methods. The greater omenta of elderly women and men were examined using anatomical preparation, somatoscopic and morphometric methods. Greater omenta were examined on 20 corpses of elderly people. The deceased had no pathology in the abdominal cavity. Based on the value of the body mass index, the body type of people was determined. Results and discussion. The greater omentum is supplied by the right and left gastroepiploic arteries. These arteries form the superior arterial arch in 15 of 18 cases, and in 3 cases the arch was absent. The inferior arterial arch was evident in 1 of 20 cases. The left gastroepiploic artery in 2 of 20 cases was absent on the anterior plate of the greater omentum and was detected in the thickness of the posterior plate of the greater omentum. From the right gastroepiploic artery central, right medial, right intermediate and right lateral arteries depart. In two out of 20 cases, the left accessory artery departed from the right gastroepiploic artery, which was located in the left half of the greater omentum. The central artery of the greater omentum has a greater length and outer diameter in men. The branches of the right gastroepiploic artery supply the right half of the greater omentum and reach the lower edge of its free part. The left gastroepiploic artery branches into the left medial, left intermediate and left lateral arteries, which branch in the thickness of the left half of the omentum, supplying it without reaching the lower edge of its free part. In 45% quadrangular, 15% – triangular and 40% – irregular shape of the greater omentum with two or more lobes were revealed. The zone of the central, and in its absence, the right medial and left medial arteries of the greater omentum is most convenient for excision of the flap for transplantation with quadrangular and triangular forms of the greater omentum in the elderly. Conclusion. In elderly people, the shape of the greater omentum does not depend on their body type. The quadrangular omenta have the largest area, the smaller triangular and irregular ones. The presence of adipose tissue in the greater omentum depends on body weight. It is advisable to perform laparoscopy before omentoplasty in a patient with excessive body weight. With age, the appearance of the greater omentum changes due to the presence of adipose tissue. We have identified the following forms of the greater omentum, depending on the presence of the severity of adipose tissue: it was transparent, like fine lace; large omentum with excessively developed adipose tissue covering the omentum with a continuous layer.