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The descending colon measures up to 25 cm in length and is secondarily retroperitoneal. It descends down attached to the left posterior abdominal wall into the left iliac fossa where it continues as the sigmoid colon. Peritoneum covers the anterior and lateral surfaces.
- anteriorly: loops of small intestine, anterior abdominal wall, greater omentum
- posteriorly: posterior abdominal wall
- distal descending colon crosses over external iliac and gonadal vessels
- laterally: left paracolic gutter
- medially: left infracolic space
- branches of inferior mesenteric artery
- descending branch of left colic artery: proximal descending colon
- sigmoid arteries: distal descending colon
Lymphatics travel with vessels to the inferior mesenteric group.