The parietal peritoneum lines the inner surface of the abdominal and pelvic walls and the underside of the diaphragm. It is attached to the walls by a layer of extraperitoneal fat and connective tissue. It shares the somatic nerve supply of the overlying body wall, so it is sensitive to pain, temperature, touch and pressure.
| Location | Inner surface of the anterior, lateral and posterior abdominal walls, the pelvic walls and the inferior surface of the diaphragm |
|---|---|
| Parts |
|
| Nerve Supply | Lower six thoracic intercostal and subcostal nerves; Iliohypogastric and ilioinguinal nerves (L1); Phrenic nerve (central diaphragmatic part); Obturator nerve (part of the pelvic wall) |
| Blood Supply | Lower intercostal arteries; Subcostal arteries; Lumbar arteries; Superior and inferior epigastric arteries; Deep circumflex iliac arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Lines the cavity, secretes and absorbs peritoneal fluid and signals well-localised pain when irritated.
Because its pain is sharp and well localised, irritation of the parietal peritoneum explains why appendicitis pain shifts from the umbilicus to the right iliac fossa. Peritonitis produces guarding, rigidity and rebound tenderness. Irritation of its diaphragmatic part, supplied centrally by the phrenic nerve (C3-C5), refers pain to the shoulder tip.
Inflammation of the parietal peritoneum next to a diseased organ, giving sharp localised pain and tenderness, as in appendicitis or cholecystitis.
Deposits of cancer, most often from ovary, stomach or colon, seeding the peritoneal surfaces and causing ascites.
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