Phrenicocolic Ligament

ligamentum phrenicocolicum

The phrenicocolic ligament is a fold of peritoneum connecting the left colic flexure (splenic flexure of the transverse colon) to the diaphragm at the level of the 10th and 11th ribs. It forms a horizontal shelf below the spleen, supporting the inferior pole of the spleen and creating the left subphrenic compartment. It also forms the lateral boundary between the greater sac and the perisplenic space.

Region: Abdomen

Biomechanics

Function & Actions

Anchors the splenic flexure of the colon to the diaphragm, provides inferior support for the spleen, and delineates compartments of the left upper abdomen relevant to fluid accumulation and abscess formation.

Clinical Relevance

Clinical Notes

The phrenicocolic ligament is divided during mobilisation of the splenic flexure of the colon, a critical step in left hemicolectomy, sigmoid resection, and anterior resection for rectal cancer. Inadequate splenic flexure mobilisation is a common cause of tension in colorectal anastomoses. In left subphrenic abscess, the phrenicocolic ligament forms the inferior wall of the collection space accessible to percutaneous drainage.

Pathology

Common Injuries & Conditions

Splenic Flexure Mobilisation Injury

Division of the phrenicocolic ligament during colorectal surgery risks inadvertent entry into the splenic capsule or injury to the inferior pole of the spleen, causing haemorrhage that may necessitate splenectomy in an operation planned as a colonic procedure.