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Lymphatic vessels and nodes of the abdominal cavity
Last reviewed: 07.07.2025
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In the abdominal cavity, visceral (internal) and parietal (wall) lymph nodes are also distinguished.
Visceral lymph nodes (nodi lymphatici viscerales) are located near the unpaired visceral branches of the abdominal aorta and their branches (near the celiac trunk, hepatic, splenic and gastric arteries, superior and inferior mesenteric arteries and their branches). Celiac lymph nodes (nodi lymphatici coeliaci, 1-5 in total) are located near the celiac trunk on the lymph flow paths from many visceral lymph nodes of the abdominal cavity. Lymphatic vessels from the nodes of the stomach, pancreas and spleen, from the renal and hepatic lymph nodes approach the celiac lymph nodes. The efferent lymphatic vessels of the celiac nodes go to the lumbar lymph nodes and also flow into the initial section of the thoracic duct.
The gastric lymph nodes (nodi limphatici gastrici) are located near the lesser and greater curvatures of the stomach, along the course of its arteries, and seem to surround the stomach. The left gastric lymph nodes (7-38) are located near the left gastric artery and its branches. These nodes are adjacent to the lesser curvature of the stomach and its walls (anterior and posterior). They receive lymphatic vessels formed in the thickness of that part of the anterior and posterior walls of the stomach that form its lesser curvature. The lymph nodes located near the cardiac part (cardia) of the stomach and encircling the inlet part from all sides in a chain are called the lymphatic ring of the cardia (annulus lymphaticus cardiae, 1-11 in total), or "cardiac lymph nodes" (nodi lymphatici cardiaci - BNA). The lymphatic vessels of the cardiac part of the stomach and its bottom, as well as from the abdominal part of the esophagus, are directed to these nodes.
The right gastric lymph nodes (1-3) are inconstant and are located along the artery of the same name above the pylorus.
The pyloric lymph nodes (nodi lymphatici pilorici, 1-16 in total) are located above, behind and below the pylorus (on the head of the pancreas), next to the superior gastroduodenal artery. Lymphatic vessels flow into the pyloric nodes not only from the pylorus, but also from the head of the pancreas.
Along the greater curvature of the stomach are the right and left gastroepiploic nodes. They lie in the form of chains near the arteries and veins of the same name and receive lymphatic vessels, which receive lymph from the walls of the stomach adjacent to the greater curvature, as well as from the greater omentum.
The right gastroepiploic lymph nodes (nodi lymphatici gastroomentalis dextri, 1-49 in total) are located in the gastrocolic ligament, at the right half of the greater curvature of the stomach, and are adjacent to the right gastroepiploic artery and vein. The left gastroepiploic lymph nodes (nodi lymphatici gastroomentalis sinistri, 1-17 in total) are located in the area of the left half of the greater curvature of the stomach, along the course of the artery and vein of the same name, between the layers of the gastrocolic ligament. At the upper edge of the pancreas (near the splenic artery and vein), on its posterior and anterior surfaces, are the pancreatic lymph nodes (nodi lymphatici pancreatici, 2-8 in total), receiving lymphatic vessels from the pancreas. The splenic lymph nodes [nodi lymphatici lienales (splenici), 3-6 in total] are located in the hilum of the spleen, near the branching of the splenic artery and the formation of the splenic vein, in the thickness of the gastrosplenic ligament. Lymphatic vessels from the fundus of the stomach, the left gastroepiploic lymph nodes and from the capsule of the spleen are directed to these nodes.
Between the head of the pancreas and the wall of the duodenum, at the point where the common bile duct enters it, and also near the branching point of the superior and inferior pancreaticoduodenal arteries, are the pancreaticoduodenal lymph nodes (nodi lymphatici pancreaticoduodenales), regional for the head of the pancreas and the duodenum. One of the nodes of this group, usually large in size, is located behind the upper part of the duodenum and takes part in the formation of the anterior wall of the omental opening. Therefore, it received the corresponding name - the node of the omental opening (nodus foraminalis). An increase in the size of this node can narrow the entrance to the omental bursa.
The hepatic lymph nodes (nodi lymphatici hepatici, 1-10 in total) are located in the thickness of the hepatoduodenal ligament along the common hepatic artery and portal vein. They are also located near the neck of the gallbladder - these are the gallbladder lymph nodes (nodi lymphatici cystici). There are only 1-2 of them, they receive lymphatic vessels from the liver and gallbladder. In rare cases (about 2%), the lymphatic vessels of the liver flow directly into the thoracic duct. The efferent lymphatic vessels of the hepatic and gallbladder lymph nodes are directed to the celiac and lumbar lymph nodes.
The most numerous group of visceral lymph nodes of the abdominal cavity are the mesenteric lymph nodes (nodi lymphatici mesenterici). There are from 66 to 404 of them, they are located in the mesentery of the small intestine near the superior mesenteric artery and vein, their branches and tributaries in the form of three subgroups. The first subgroup (peripheral) is located between the mesenteric edge of the small intestine and the vascular arches - arcades. These are the pericolonic mesenteric nodes. The nodes of the second subgroup (middle) are adjacent to the trunks, branches and tributaries of the superior mesenteric artery and vein, and the nodes of the third - central subgroup are located near the superior mesenteric vessels along the length from the lower edge of the pancreas to the place of origin of the right colic artery. The lymph nodes of the central subgroup at the beginning of the superior mesenteric artery are quite closely adjacent to each other and in some cases form a kind of conglomerate.
From the jejunum and ileum, the lymphatic vessels are directed mainly to the peripheral subgroup of mesenteric lymph nodes. Some lymphatic vessels bypass these nodes and go to the nodes of the middle and even central subgroup. The efferent lymphatic vessels of the mesenteric lymph nodes (central subgroup) flow into the lumbar lymph nodes, and in some cases (about 25%) - directly into the thoracic duct, forming intestinal trunks (trunci intestinales). The lymphatic vessels of the terminal section of the ileum flow not into the mesenteric, but into the ileocolic lymph nodes.
Regional lymph nodes of the colon are nodes adjacent to the colic arteries and veins - branches and tributaries of the superior and inferior mesenteric arteries and veins. Lymphatic vessels that carry lymph from the cecum and appendix flow into numerous (3-15) relatively small cecal nodes (nodi lymphatici caecales). Among these nodes, prececal and retrocecal lymph nodes (nodi lymphatici precaecales et retrocaecales) are distinguished, located respectively near the anterior and posterior walls of the cecum. Single lymphatic vessels of this organ, as well as of the vermiform appendix, flow into the ileocolic lymph nodes (nodi fymphitici ileocolici, 1-7 in total), to which the lymphatic vessels of the terminal ileum are also directed. The lymphatic vessels of the ascending colon flow into the right colic lymph nodes (nodi lymphatici colici dextri, 7-55 in total), located near the right colic artery and vein, their branches and tributaries. From the descending colon and sigmoid colon, the lymphatic vessels go to the left colic lymph nodes (nodi lymphatici colici sinistri, 8-65 in total) and to the sigmoid lymph nodes (nodi lymphatici sigmoidei, 5-50 in total), which are located near the arteries and veins of the same name, their branches and tributaries. Lymphatic vessels from the upper part of the rectum also go to the sigmoid lymph nodes. The efferent lymphatic vessels of the sigmoid and left colic lymph nodes go to the inferior mesenteric nodes (nodi lymphatici mesenterici inferiores), and the efferent vessels of the latter flow into the lumbar lymph nodes (pariental nodes of the abdominal cavity) located near the abdominal part of the aorta and inferior vena cava.
On the paths of the lymphatic vessels from the colon to its regional lymph nodes (colonic) lie not very large paracolonic nodes (nodi lymphatici paracolici). They are located directly near the medial (lower - for the transverse colon) wall of the intestine or close to it.
The efferent lymphatic vessels of the ileocolic, mesenteric-colic, right and left colic lymph nodes are directed to the parietal lumbar lymph nodes, as well as to the central subgroup of the superior mesenteric lymph nodes, located at the beginning of the superior mesenteric artery and near the vein of the same name.
Parietal lymph nodes (nodi lymphatici parietales) of the abdominal cavity are located on the anterior abdominal wall (lower epigastric) and on the posterior abdominal wall (lumbar). The lower epigastric lymph nodes (nodi lymphatici epigastrici inferiores, 3-4 in total) are paired and lie in the thickness of the anterior abdominal wall along the course of the blood vessels of the same name. These nodes collect lymph from the adjacent parts of the rectus, transverse and oblique abdominal muscles, the peritoneum lining the anterior abdominal wall, and from the subperitoneal tissue. The efferent lymphatic vessels of these nodes are directed along the course of the lower hypogastric blood vessels downwards, to the external iliac, and upwards along the superior epigastric vessels, and then along the internal thoracic blood vessels to the parasternal lymph nodes.
Numerous lumbar lymph nodes (nodi lymphatici lumbales, 11-41 in total) are located along the entire length of the posterior abdominal wall (retroperitoneal) near the aorta and posterior vena cava. Due to the position of these nodes in relation to large vessels, they are divided into left, right and intermediate lumbar lymph nodes. The left lumbar lymph nodes (left lateroaortic) are adjacent in a chain to the abdominal part of the aorta on the left, in front and behind. In the group of these nodes, in turn, the following are distinguished: lateral aortic (nodi lymphatici aortici laterales, 1-17 in total), preaortic (nodi lymphatici preaortici, 1-14 in total) and postaortic (nodi lymphatici postaortici, 1-15 in total).
The right lumbar lymph nodes are located near the anterior, posterior, and right surfaces of the inferior vena cava along its entire length from the site of its formation from the common iliac veins to the diaphragm. These lymph nodes are subdivided into precaval (nodi lymphatici precavales, 1-7 in total), postcaval (nodi lymphatici postcavales, 1-12 in total), and lateral caval (nodi lymphatici cavales laterales, 1-4 in total). In the groove between the abdominal aorta and the inferior vena cava, there is a chain of intermediate lumbar (interaortocaval) lymph nodes (nodi lymphatici lumbales intermedin, 1-9 in total).
The listed lumbar lymph nodes together with the lymphatic vessels connecting them form a dense lymphatic plexus near the abdominal part of the aorta and the inferior vena cava. Lymph from the lower extremities, walls and organs of the pelvis passes through the lumbar lymph nodes. The efferent lymphatic vessels of the lymph nodes located near the internal organs of the abdominal cavity (gastric, mesenteric, colonic, etc.) also flow into these nodes.
The efferent lymphatic vessels of the lumbar lymph nodes form the right and left lumbar trunks, which give rise to the thoracic duct, or flow into the initial part of the duct independently.
On the posterior abdominal wall, near the inferior phrenic artery, there are paired, non-permanent inferior phrenic lymph nodes (nodi lymphatici phrenici inferiores, 1-3 in total). They are also parietal lymph nodes of the abdominal cavity. Lymphatic vessels of the diaphragm, the posterior part of the right and left lobes of the liver flow into these nodes. The efferent lymphatic vessels of the inferior phrenic nodes are directed to the celiac, postcaval and intermediate lumbar lymph nodes.
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