Stomach of an Obese White Male, Posterior View

Description

Positioned deep to the posterior abdominal wall, the ventriculus (stomach) sits predominantly in the left upper quadrant, with the abdominal esophagus descending in the midline before entering the gastric cardia just left of the vertebral column. The fundus rises superiorly under the left dome of the diaphragm, while the body curves anterolaterally toward the greater curvature, which sweeps inferiorly toward the pyloric region and proximal duodenum. Posterior relations are emphasized, placing the pancreas directly posterior to the stomach across the lesser sac, with the spleen lateral to the fundus along the gastrosplenic ligament. Subcutaneous adipose tissue increases the depth from the skin surface to the upper abdominal viscera. Posterior perspective matters when you want to teach what lies behind the stomach, because the “stomach bed” (pancreas, splenic vessels, left kidney and adrenal, and transverse mesocolon) explains both pain referral patterns and procedural risk. Pancreatitis can present with epigastric pain radiating to the back, and this relationship also frames why posterior gastric ulcers may erode into the pancreas and cause bleeding from nearby vessels. In bariatric and foregut surgery, obesity changes the working distance and obscures landmarks, so mapping the gastroesophageal junction, fundus, and splenic hilum in a larger body habitus becomes practical, not academic. It is a tight neighborhood. Use this artwork in gross anatomy and GI block teaching to orient learners to posterior upper abdominal organ relationships without relying on a cadaveric dissection plane. It also fits patient education and preoperative counseling materials for obesity-related upper GI complaints, bariatric pathways, and complications involving the spleen or pancreas. Anatomical accuracy verified by SciePro's Medical Advisory Board.