Fig. 164 shows the appearance of the fold in Nasua rufa after rotation of the intestine. The short course of the large intestine in this animal, and the consequent reduction of the mesocolon, brings the fold much below the level which it occupies in the cat.
If we now look for the corresponding structures in man we will find certain modifications depending chiefly upon still closer adhesion between duodenum and the mesocolon which is destined to become the left parietal peritoneum after anchoring of the descending colon. We have already encountered an example of such closer connection in the marmoset shown in [Fig. 162].
In all cases the “superior duodenal” fold, corresponding to the fold just encountered in the cat, is the original condition, and the duodenal fossa consequently opens caudad. In many instances this will be the only fold and fossa encountered in the adult human subject. In other instances more extensive duodeno-mesocolic adhesions result in the addition of an “inferior fold,” bounding a fossa the entrance into which is directed cephalad toward the transverse mesocolon. Such a condition is seen in Fig. 165 taken from a fœtus at term. The duodenal fossa in this case is bounded by an “upper” and “lower” duodenal fold continuous with each other on the left side, but separated on the right at their attachment to the duodenum. It will be seen that the inferior mesenteric vein runs in the left margin of the fold, following along the left border of the entrance into the fossa. A segment of the colica sinistra artery may occupy the same position. This position of the vein, or artery, or of both vessels, is not the cause leading to the formation of the duodenal fossa, but is more or less accidental and variable. In many cases the vessels run at some distance from the folds bounding the fossa.
In some subjects the “inferior” fold is the only one found, and the only duodenal fossa then encountered looks cephalad. This condition, when associated with the course of the inferior mesenteric vessels in the free edge of the fold, constituted the classical “fossa duodeno-jejunalis” of Treitz, and is described as “Treitz’s fossa.”
Fig. 166.—Abdominal viscera of human fœtus at term. (Columbia University Museum, No. 1820.)
Fig. 167.—Abdominal viscera of adult human subject, showing duodenal folds and fossa. (From a fresh dissection.)
Fig. 168.—Abdominal viscera of adult human subject, showing duodenal folds and fossa. (From a fresh dissection.)