A 61-year-old woman had been scheduled for a cholecystectomy. During the operation the scissors of the surgical resident accidentally entered the tissues immediately posterior to the epiploic (omental) foramen (its posterior boundary). The surgical field was filled immediately by profuse bleeding. Which of the following vessels was the most likely source of bleeding?
The omental (epiploic) foramen (of Winslow) is the only natural opening between the lesser and greater sacs of the peritoneal cavity. It is bounded superiorly by the visceral peritoneum (liver capsule of Glisson) on the caudate lobe of the liver, inferiorly by the peritoneum on the first part of the duodenum, anteriorly by the free edge of the hepatoduodenal ligament, and posteriorly by the parietal peritoneum covering the inferior vena cava. Therefore, the inferior vena cava would be the most likely source of bleeding. The aorta lies to the left of the inferior vena cava in the abdomen. The portal vein, right renal artery, and superior mesenteric vein are not borders of the epiploic foramen.
Aorta
Inferior vena cava
Portal vein
Right renal artery
Abdomen & Pelvis