The gastrosplenic ligament is a fold of peritoneum connecting the greater curvature of the stomach to the hilum of the spleen. It is a remnant of the dorsal mesogastrium and contains the short gastric vessels and the left gastroepiploic artery along its inferior aspect. Together with the splenorenal (lienorenal) ligament, it forms the two-layer suspension of the spleen within the peritoneal cavity.
Suspends the spleen from the greater curvature of the stomach, transmits the short gastric vessels from the splenic hilum to the gastric fundus, and contributes to the left sided closure of the lesser sac.
The gastrosplenic ligament must be divided during splenectomy and left-sided gastrectomy to mobilise the spleen and the gastric fundus. The short gastric vessels within it require individual ligation during total gastrectomy and sleeve gastrectomy. In laparoscopic Nissen fundoplication, the short gastrics within the gastrosplenic ligament are divided to allow adequate gastric fundus mobilisation for wrap formation. Pathological volvulus of the gastrosplenic ligament can occur in wandering spleen.
Laxity of the gastrosplenic and splenorenal ligaments allows the spleen to migrate from its normal position and twist on its pedicle, producing acute splenic ischaemia requiring emergency detorsion and splenorrhaphy or splenopexy.
Inadvertent avulsion of the short gastric vessels within the gastrosplenic ligament during splenectomy or gastric mobilisation causes gastric fundus ischaemia and potential anastomotic leak in oesophageal or gastric reconstruction procedures.
