Greater Curvature of the Stomach

The greater curvature of the stomach is the long, convex lateral border of the stomach, extending from the cardiac notch to the pylorus. It forms the outer curve of the stomach and serves as a key anatomical surface for the attachment of peritoneal folds and blood vessels. Due to its prominent length and positioning, it plays important roles in surgical orientation, vascular supply, and anchorage of surrounding visceral structures.

Structure

The greater curvature begins at the cardiac notch (incisura cardiaca), arches down the left lateral aspect of the stomach, curves around the inferior border, and ends at the pyloric sphincter on the right. It is approximately four to five times longer than the lesser curvature and follows the contour of the fundus, body, and pyloric regions of the stomach.

Its surface is covered by visceral peritoneum and forms the point of attachment for the greater omentum, a large apron-like peritoneal fold that drapes over the intestines. Beneath the peritoneum lies the gastric wall, which includes:

• Mucosa with gastric rugae
• Submucosa rich in connective tissue and vessels
• Muscularis externa with three muscle layers
• Serosa (visceral peritoneum)

Arterial Supply

The greater curvature is supplied by:

• Right gastroepiploic artery (branch of the gastroduodenal artery)
• Left gastroepiploic artery (branch of the splenic artery)

These arteries anastomose along the curvature and run within the layers of the greater omentum.

Location

The greater curvature spans the inferolateral border of the stomach and is positioned:

• Lateral to the fundus and body
• Inferior to the liver (right) and diaphragm (left)
• Anterior to the transverse colon and small intestine

Its attachment to the greater omentum also creates the anterior boundary of the greater sac, the main compartment of the peritoneal cavity.

Function

The greater curvature has several anatomical and functional roles:

• Support structure: Anchors the greater omentum, which contains fat, lymphatics, and immune cells.
• Conduit for vasculature: Facilitates passage of the gastroepiploic vessels to the stomach and greater omentum.
• Expansion zone: Its large surface area allows for significant gastric expansion during food intake.
• Surgical reference: Frequently used as a guide during gastrectomy and gastric bypass procedures.

Clinical Significance

The greater curvature is an important site in various medical and surgical contexts:

• Gastric ulcers: Less common than on the lesser curvature but may still develop here, particularly with NSAID use or malignancy.
• Gastric cancer: Tumors may arise along the greater curvature and can extend into the omentum or peritoneum.
• Gastrectomy: During subtotal or total gastrectomy, the greater curvature is often mobilized and resected. Preservation or ligation of the gastroepiploic arteries is essential.
• Omental transposition: The greater omentum attached here can be mobilized for surgical procedures such as reinforcing anastomoses or covering exposed organs.
• Obesity surgery: In sleeve gastrectomy, the greater curvature is removed to reduce stomach volume.

The long course and rich vascular supply of the greater curvature make it a significant landmark in abdominal surgery and pathology. Its close association with the omentum also plays a role in immune defense and the localization of intra-abdominal infections.