Greater curvature of stomach

The greater curvature of stomach is the long, convex border of the stomach and is approximately four to five times longer than the lesser curvature. It begins at the cardiac notch near the cardiac orifice, arches upward, backward, and to the left over the fundus, reaching its highest point at the level of the left sixth costal cartilage. From there, it descends along the left border of the stomach with a gentile convexity before turning to the right and ending at the pylorus, where the stomach becomes continuous with the first part of the duodenum.

Greater curvature and pyloric region of stomach

Opposite the incisura angularis of the lesser curvature, the greater curvature presents a slight dilatation that forms the left extremity of the pyloric part of the stomach. This dilated region corresponds to the pyloric antrum, the wider proximal portion of the pyloric region that serves as a reservoir where food is mixed and ground before gastric emptying. The antrum is separated from the narrower distal part of the pyloric region by a shallow groove known as the sulcus intermedius, located approximately 2.5 cm proximal to the pyloroduodenal junction. The sulcus intermedius marks the transition between the pyloric antrum and the pyloric canal. The pyloric canal extends from the sulcus intermedius to the pylorus and is a narrow tubular segment that terminates at the pyloric sphincter, which regulates the passage of gastric contents into the duodenum.

Peritoneal folds along the greater curvature of stomach

The greater curvature is covered by visceral peritoneum (serosa) and provides attachment to several important peritoneal folds:

• Near the fundus, it is attached to the gastrophrenic ligament, which connects the stomach to the diaphragm.

• The upper left part gives attachment to the gastrosplenic ligament, which connects the stomach to the spleen and transmits the short gastric and left gastro-omental vessels.

• Along most of its length, the greater curvature provides attachment to the greater omentum, a large apron-like fold of peritoneum that hangs from the stomach and proximal duodenum before descending in front of the intestines..

Vasculature and lymphatics along the greater curvature of stomach

• The arterial supply of the greater curvature of stomach is provided mainly by the right and left gastroomental (gastroepiploic) arteries, which run along the curvature and anastomose with each other. The fundus also receives branches from the short gastric arteries.

• Venous drainage follows the corresponding veins and ultimately enters the portal venous system.

• Lymph from the greater curvature drains to the gastroomental lymph nodes, then to the pancreaticosplenic, pyloric, and finally the coeliac lymph nodes.