[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Greater omentum [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Greater omentum The greater omentum is a fatty apron of peritoneum hanging from the stomach over the intestines; it moves to wall off infection and inflammation. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=greater_omentum&side=r) Opens in the Durgical app, no sign-up needed. ## What it is An apron of fatty peritoneum hanging from the stomach over the intestines. ## What it does Stores fat and moves to wall off infections (the 'abdominal policeman'); the first thing seen when the [abdomen](https://durgical.com/en/anatomy/region/abdomen/) is opened. ## Key points - It moves toward and sticks to inflamed areas, walling off appendicitis or a perforation; it is short and less effective in young children - A common site of peritoneal metastases («omental cake»), especially from ovarian and gastric cancer - The space between its folded layers is the lowest part of the lesser sac, usually closed off in adults ## Key facts **Where** Four-layered apron hanging from greater curvature of stomach over transverse colon and small intestine **Attaches** Greater curvature and first part of duodenum; posterior layers fuse with transverse colon; includes gastrocolic, gastrosplenic and gastrophrenic ligaments **Function** Stores fat; immune milky spots; adheres to and walls off inflammation ('abdominal policeman'); carries gastroepiploic vessels ## Relations **Above** Greater curvature of the [stomach](https://durgical.com/en/anatomy/stomach/) and the first part of the [duodenum](https://durgical.com/en/anatomy/duodenum/); to the left it continues as the gastrosplenic ligament **Behind** [Transverse colon](https://durgical.com/en/anatomy/transverse-colon/) and transverse [mesocolon](https://durgical.com/en/anatomy/mesocolon/), then coils of small intestine **In front** Parietal [peritoneum](https://durgical.com/en/anatomy/peritoneum/) of the anterior abdominal wall **Contents** Right and left gastroepiploic (gastro-omental) vessels along the greater curvature, fat, lymph nodes and milky spots ## How to find it At laparotomy it lies in front of the bowel; lifting it upward with the transverse colon exposes the small intestine. In appendicitis or a perforation, the place where it is stuck often marks the source. ## On imaging On CT, nodular or sheet-like thickening of the fat under the anterior abdominal wall (omental cake) suggests peritoneal carcinomatosis. Omental infarction shows a fatty mass with stranding, usually on the right, and can mimic appendicitis. ## Common problems - Peritonitis: infection or inflammation, usually from a burst organ ([appendix](https://durgical.com/en/anatomy/vermiform-appendix/), ulcer); severe pain and a rigid abdomen. An emergency. ## How it is diagnosed Examination, blood tests, CT. ## Treatment - Treat the source (often surgery) and antibiotics. ## Clinical notes - Omental patch (Graham patch): a [tongue](https://durgical.com/en/anatomy/tongue/) of omentum is sewn over a perforated duodenal ulcer - Omental flap: based on a gastroepiploic artery, it can be moved to fill [chest](https://durgical.com/en/anatomy/region/chest/) or infected sternal wounds - Omentectomy is part of the staging and debulking surgery for ovarian cancer ## Development It develops from the dorsal mesogastrium, which grows to the left and downward as the stomach rotates, folding over the transverse colon. ## Related conditions - [Peritonitis](https://durgical.com/en/conditions/peritonitis/) - [Obesity](https://durgical.com/en/conditions/obesity/) - [Metabolic syndrome](https://durgical.com/en/conditions/metabolic-syndrome/) - [Intra-abdominal abscess](https://durgical.com/en/conditions/intra-abdominal-abscess/) ## Test yourself Think of the answer, then tap the question to see it. ## Why is the greater omentum called the «abdominal policeman»? It moves toward and sticks to inflamed areas, walling off appendicitis or a perforation; it is short and less effective in young children. ## Which vessels run in the greater omentum? The right and left gastroepiploic (gastro-omental) vessels along the greater curvature of the stomach. ## What is an «omental cake» on CT? Nodular or sheet-like thickening of the greater omentum from peritoneal metastases, especially from ovarian and gastric cancer. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/greater-omentum/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** omentum majus TA2 3757 **Official Spanish (DeCS)** Omento mayor DeCS D009852 **English (TA2)** Greater omentum ## Related - [Transverse colon](https://durgical.com/en/anatomy/transverse-colon/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=10037&filter=ths_termall&q=Epipl%C3%B3n); [Anatomy, Abdomen and Pelvis, Peritoneum](https://www.ncbi.nlm.nih.gov/books/NBK534788/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/greater-omentum/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/greater-omentum/