[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/) › Transverse colon [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Transverse colon The transverse colon is the part of the large intestine that crosses the upper belly from right to left, below the stomach. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=transverse_colon&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The part of the colon crossing the upper [abdomen](https://durgical.com/en/anatomy/region/abdomen/), hanging from the transverse mesocolon. ## What it does Moves contents from right to left. ## Key points - The splenic flexure is a watershed between the middle colic (SMA) and left colic (IMA) territories, where the marginal artery can be weak (Griffiths point): a classic site of ischemic colitis - The greater omentum joins it through the gastrocolic ligament; opening that ligament enters the lesser sac, the usual route to the back of the stomach and the pancreas - The middle colic artery runs in the transverse mesocolon and is at risk in gastric, pancreatic and colonic surgery ## Key facts **Where** From hepatic to splenic (left colic) flexure; intraperitoneal on transverse mesocolon; most mobile part of colon **Blood supply** Middle colic artery (SMA) for proximal two-thirds; left colic (IMA) for distal third; watershed at splenic flexure **Nerve** Proximal two-thirds: [superior mesenteric plexus](https://durgical.com/en/anatomy/superior-mesenteric-plexus/) and vagus; distal third: inferior mesenteric plexus and pelvic [splanchnic nerves](https://durgical.com/en/anatomy/greater-thoracic-splanchnic-nerve/) (S2–S4) **Function** Absorbs water; carries contents right to left; midgut–hindgut junction at its distal third ## Relations **Above** Greater curvature of the [stomach](https://durgical.com/en/anatomy/stomach/) (joined by the gastrocolic ligament), the [liver](https://durgical.com/en/anatomy/liver/) and [gallbladder](https://durgical.com/en/anatomy/gallbladder/) on the right, the [spleen](https://durgical.com/en/anatomy/spleen/) at the splenic flexure **In front** [Greater omentum](https://durgical.com/en/anatomy/greater-omentum/) and the anterior abdominal wall **Behind** Transverse [mesocolon](https://durgical.com/en/anatomy/mesocolon/), whose root crosses D2 and the head and body of the [pancreas](https://durgical.com/en/anatomy/pancreas/) **Below** Loops of [jejunum](https://durgical.com/en/anatomy/jejunum/) and [ileum](https://durgical.com/en/anatomy/ileum/) in the infracolic compartment **Lateral** Left end: the splenic flexure, higher than the hepatic flexure and tied to the [diaphragm](https://durgical.com/en/anatomy/diaphragm/) by the phrenicocolic ligament ## How to find it Its height varies: it may sag to the umbilicus or lower when standing. At laparotomy it is lifted with the greater omentum to expose the small bowel; at colonoscopy its lumen looks triangular. ## On imaging In toxic megacolon of ulcerative colitis, a supine abdominal X-ray shows a dilated transverse colon (often more than about 6 cm), because gas rises to it. Colon placed between the liver and diaphragm (Chilaiditi sign) can mimic free air under the diaphragm. ## Common problems - Colon polyps and colorectal cancer: screening finds them early. - Diverticular disease and diverticulitis (usually sigmoid). - Ulcerative colitis and Crohn disease. ## How it is diagnosed Colonoscopy; CT; stool tests for screening. ## Treatment - Polyps removed during colonoscopy; surgery (colectomy) for cancer or complicated disease. ## Clinical notes - Mobilizing the splenic flexure (dividing the phrenicocolic and splenocolic attachments) risks tearing the splenic capsule - Pain from its proximal two thirds (midgut) is felt around the umbilicus; from the distal third (hindgut), in the suprapubic region - Gastric and pancreatic cancers can invade it through the gastrocolic ligament and transverse mesocolon ## Anatomical variants - Hepatodiaphragmatic interposition (Chilaiditi sign): a loop of colon, usually the hepatic flexure or the transverse colon, lies between the liver and the right hemidiaphragm; on a [chest](https://durgical.com/en/anatomy/region/chest/) X-ray it can be mistaken for free air, but haustral folds show inside the gas ## Development Its proximal two thirds come from the midgut ([superior mesenteric artery](https://durgical.com/en/anatomy/superior-mesenteric-artery/), vagus) and its distal third from the hindgut ([inferior mesenteric artery](https://durgical.com/en/anatomy/inferior-mesenteric-artery/), pelvic splanchnic nerves). The back layer of the greater omentum fuses with the transverse mesocolon, which is why the omentum appears to hang from the colon. ## Related conditions - [Ulcerative colitis](https://durgical.com/en/conditions/ulcerative-colitis/) - [Clostridioides difficile infection](https://durgical.com/en/conditions/clostridioides-difficile-infection/) - [Colorectal polyps and hereditary polyposis syndromes (FAP, Lynch)](https://durgical.com/en/conditions/colorectal-polyps-and-hereditary-polyposis-syndromes/) - [Paralytic ileus and colonic pseudo-obstruction (Ogilvie)](https://durgical.com/en/conditions/paralytic-ileus-and-colonic-pseudo-obstruction/) - [Microscopic colitis](https://durgical.com/en/conditions/microscopic-colitis/) - [Cytomegalovirus infection](https://durgical.com/en/conditions/cytomegalovirus-infection/) - [Postoperative ileus](https://durgical.com/en/conditions/postoperative-ileus/) ## Test yourself Think of the answer, then tap the question to see it. ## Why is the splenic flexure a classic site of ischemic colitis? It is the watershed between middle colic (SMA) and left colic (IMA) territories, where the marginal artery can be weak (Griffiths point). ## Which arteries supply the transverse colon? The middle colic artery (SMA) for the proximal two thirds and the left colic artery (IMA) for the distal third. ## Which ligament is opened to enter the lesser sac along the transverse colon? The gastrocolic ligament, joining the greater curvature to the transverse colon; it is the usual route to the back of the stomach and the pancreas. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/transverse-colon/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** colon transversum TA2 2984 **Official Spanish (DeCS)** Colon transverso DeCS D044684 **English (TA2)** Transverse colon ## Related - [Ascending colon](https://durgical.com/en/anatomy/ascending-colon/) - [Descending colon](https://durgical.com/en/anatomy/descending-colon/) - [Greater omentum](https://durgical.com/en/anatomy/greater-omentum/) - [Colic arteries](https://durgical.com/en/anatomy/right-colic-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=37757&filter=ths_termall&q=Colon%20Transverso); [Anatomy, Abdomen and Pelvis: Large Intestine](https://www.ncbi.nlm.nih.gov/books/NBK470577/); [23.5 The Small and Large Intestines](https://openstax.org/books/anatomy-and-physiology-2e/pages/23-5-the-small-and-large-intestines) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/); Anatomy of the Human Body (20th ed.): The Digestive Apparatus (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain. ## **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/transverse-colon/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/transverse-colon/