This begins at the hepatic flexure at the inferior surface of the right lobe of liver at its junction with ascending colon. It ends at the splenic flexure at the lower part of the spleen and also at the tail of the pancreas, at junction with descending colon. At this flexure, the colon is attached to the diaphragm by the phrenicocolic ligament at the level of ribs 10 and 11. It is about 50 cm long and it is longer than the width of the abdomen and hence makes a curvature downwards. Because the splenic flexure is higher than the hepatic flexure, the transverse colon runs upwards from its concavity.

It has a long mesentery and is therefore completely intraperitonealized, called the transverse mesocolon.

Arteries:

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Middle colic artery (proximal 2/3)

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Marginal branch of left colic artery (distal 1/3).

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Middle colic artery is from the superior mesenteric artery while the left colic artery is a branch of the inferior mesenteric artery.

Veins:

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Middle colic vein (proximal 2/3)

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Marginal tributary of left colic vein (distal 1/3).

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Marginal tributary of the left colic vein is a tributary of the inferior mesenteric vein, while the Middle colic vein  is a tributary of the superior mesenteric vein. Inferior mesenteric vein enters the splenic vein while the superior mesenteric vein forms the portal vein with the splenic vein. The veins end in the portal vein.

Nerves:

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Vagus nerve.

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Nervi erigentes for the distal 1/3 of transverse colon.

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Sympathetic fibers from the thoracic splanchnic nerves, which relay in the superior mesenteric ganglion for proximal 2/3 of transverse colon.

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Sympathetic fibers are from the lumbar splanchnic nerves, which relay in the inferior mesenteric ganglion of the inferior mesenteric plexus and are from the superior hypogastric plexus for the distal 1/3.

Relations

The transverse colon has variable relations since it is highly mobile. It may reach the level of the umbilicus but is usually superior to it. It is placed posterior to the liver and gallbladder at the hepatic flexure, but anterior to the coils of intestine, 2nd part of duodenum, and the head of pancreas. A the splenic flexure, it is anterior to the left margin of left kidney, inferior to the spleen and posterior to the greater omentum.



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