Anatomy of the colon. Guide to intra-abdominal pathology. Hickey Lecture, 1975

The normal contours and relationships of the colon have been described in a previous publication. I have attempted to show how enlargement of these organs or tumefactions arising within them affect the colon in a characteristic manner. Hopefully this will become useful in: (1) determining the normality of the external contour and variation of the external contour of the colon; (2) detecting a clinically unsuspected mass by an abnormal indentation on the colon; and (3) providing, for the diagnostic work-up of abdominal masses, a primary classification fo abdominal masses. Further, I have tried to emphasize that the lateral aspects of both colic flexures are posterior and tend to reflect abnormality of the posterior structures. The medial aspects of the colic flexures are anteior and likewise reflect abnormality of anterior structures. In addition, I reemphasize that what in the past has been called the splenic flexure (the area of marked angulation of the colon in the left upper quadrant) in reality is merely a portion of distal transverse colon. The more subtle angulation of the colon related to the "splenic angle" and left kidney is the true splenic flexure, the area of the phrenicocolic ligament.