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Journal articles on the topic 'Ligamentum of venosum of the liver'

Author: Grafiati

Published: 7 June 2025

Last updated: 17 July 2025

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1

Jayarathna, M. J. S., and H. A. Amaratunga. "An interlobar ligament connecting the right and left lobes of the liver – A cadaveric case report." Sri Lanka Anatomy Journal 7, no. 1 (2023): 40–44. http://dx.doi.org/10.4038/slaj.v7i1.183.

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Several ligaments and peritoneal folds attach the liver to other organs and to the abdominal wall. These are the falciform ligament, ligamentum teres hepatis or round ligament, right triangular ligament, left triangular ligament, lessor omentum, and ligamentum venosum. We report a unique ligament connecting the right and left lobes of the liver, on its visceral surface near its inferior border. This ligament is seen forming a tunnel through which the ligamentum teres is seen to travel.The knowledge can be used by the radiologists and clinicians in image interpretation and subsequent clinical diagnosis and by anatomists and embryologists for academic interests. Further, this ligament and the tunnel formed by it maybe a potential site for strangulation of abdominal content.

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2

Bedi, Agamdeep Singh, Akash Chopra, Adya Khanna, and Shilpa M. Bhimalli. "A Cadaveric Study on the Morphology and Congenital Anomalies of the Liver." Journal of the Scientific Society 52, no. 2 (2025): 136–40. https://doi.org/10.4103/jss.jss_163_24.

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Introduction: The liver is a large, wedge-like abdominal organ which occupies the right and left hypochondriac, epigastric regions. Anatomically, the liver is divided into right and left lobes by the falciform ligament anteriorly, fissure of ligamentum teres inferiorly, and fissure for ligamentum venosum posteriorly. The right lobe includes the caudate and quadrate lobes. Aim: The aim of the study was to study the morphological variations and congenital anomalies of the human liver. Materials and Methods: From the Department of Anatomy, KAHER’s J. N. Medical College, Belagavi, 40 human adult livers were obtained from cadavers of both sexes. They were classified based on their morphology, and a few anomalies were also observed. Results: Based on the data collected, livers were classified according to Netter’s classification based on morphology: • Type 1 – 5/40 • Type 2 – 0/40 • Type 3 – 2/40 • Type 4 – 7/40 • Type 5 – 4/40 • Type 6 – 9/40 • Normal: 13/40 • Congenital anomalies found • Monocystic liver: 1/40 • Agenesis of quadrate lobe: 3/40 • Fusion of quadrate and left lobe-4/40. Conclusion: Knowing about the variations of liver morphology will help clinicians avoid diagnostic errors. This helps prevent fatal surgical complications and will help in planning appropriate surgical approaches.

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3

Sharma, Ruchi, Yogesh Yadav, Pankaj Wadhwa, Ashish Gautam, and Nisha Kaul. "Cadaveric study of morphology of caudate lobe of the liver in North Indian population." European Journal of Anatomy 26, no. 5 (2022): 567–75. http://dx.doi.org/10.52083/euzm3304.

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The caudate lobe is a vertically elongated central projection from posterior surface of liver. It is bordered on the right by the groove for the inferior vena cava (IVC), on the left by the fissure for the ligamentum venosum, and on the bottom by the porta hepatis. It is continuous on the superior aspect with the upper part of the right limb of the fissure for the ligamentum venosum. The morphology of the caudate lobe was studied in 100 cadaveric human livers (15-70 years old) stored in 10% formaldehyde, regardless of gender, obtained from the department of anatomy at Santosh Medical College in Ghaziabad. The caudate lobe was observed in a variety of shapes. Vertical fissures extending upward from the lower border of the caudate lobe were seen in 52% of the liver specimens, while accessory caudate fissures extending downward from the upper border were seen in 9% and accessory transverse fissures were seen in 3% cases. Caudate notch was horizontal in 11% of liver specimens. The papillary process was visible in 27% of the liver specimens; a hook shape of the papillary process was seen in one liver specimen. Caudate process was present in 18% of the cases. Linguiform process was observed in 46% of cadaveric liver specimens. As observed, the incidences of morphological variations of the caudate lobe are very high, so it is critical for both radiologists and surgeons to keep these variations in mind when making diagnoses and planning surgeries for a favourable clinical outcome.

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Pulakunta, Thejodhar, Bhagath Kumar Potu, Vasavi Rakesh Gorantla, Venkata Ramana Vollala, and Jency Thomas. "Surgical importance of variant hepatic blood vessels: a case report." Jornal Vascular Brasileiro 7, no. 1 (2008): 84–86. http://dx.doi.org/10.1590/s1677-54492008000100016.

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This report describes a variation in blood vessels of the liver and abnormal entry of hepatic arteries into the liver found during routine dissection in an approximately 43-year-old male cadaver. An accessory hepatic artery arose from the superior mesenteric artery and entered the liver at the porta hepatis, whereas the proper hepatic artery was seen entering the left liver lobe at the fissure for ligamentum venosum. Clinical implications of such variation are discussed in the article.

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5

SK, Sah. "Study of Variations in the Morphology of Liver in the Nepalese Cadavers." Journal of Human Anatomy 4, no. 1 (2020): 1–5. http://dx.doi.org/10.23880/jhua-16000145.

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Backgrounds: Liver is the largest viscera, located in the right hypochondrium, epigastrium and left hypochondrium of the abdominal cavity. It is a wedge-shaped organ with its narrow end pointed towards the left. It is convex in the front, to the right, above, and behind, and is somewhat concave inferiorly, where it is moulded to the shapes of the adjacent viscera. Even though the surface is smoothly continuous, liver is customarily apportioned by the anatomists into a larger right and a smaller left lobe by the line of attachment of the falciform ligament anteriorly and the fissure for ligamentum teres and ligamentum venosum on inferior surface. Materials and Methods: The present study was conducted on 50 formalin fixed livers and gall bladders during routine labex of undergraduate students in the dissection hall of Anatomy department of Nobel Medical College Teaching Hospitals, Biratnagar, Nepal in the period of 3 years starting from June 2016 to May 2019. Each of the specimens was studied for morphological variations. Results: In the present study the livers with normal architectures were considered normal. Out of 50 liver specimens, 21 were normal without any gross anomalies with normal architecture. The remaining 29 specimens showed some short of accessory fissures and lobes on the different lobes of the liver. Out of 29 specimens in 2 specimens lingular process was observed arising from the left lobe. Hypoplastic left lobes was also observed in 2 specimens. Conclusions: Knowledge of morphological variations like atrophy, agenesis, presence of accessory lobes and fissures, presence of intrahepatic gall bladder and absence of normal fissure and lobe can cause diagnostic error in interpretation for the anatomists, radiologists and surgeons.

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6

Dutta, Sukhendu, and Bimalendu Mukerjee. "Accessory hepatic artery: incidence and distribution." Jornal Vascular Brasileiro 9, no. 1 (2010): 25–27. http://dx.doi.org/10.1590/s1677-54492010005000006.

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Background: Anatomic variations of the hepatic arteries are common. Preoperative identification of these variations is important to prevent inadvertent injury and potentially lethal complications during open and endovascular procedures. Objective: To evaluate the incidence, extra-hepatic course, and presence of side branches of accessory hepatic arteries, defined as an additional arterial supply to the liver in the presence of normal hepatic artery. Methods: Eighty-four human male cadavers were dissected using a transperitoneal midline laparotomy. The supra-celiac aorta, celiac axis, and hepatic arteries were dissected, and their trajectories were identified to describe arterial branching patterns. Results: Normal hepatic arterial anatomy was identified in 95% of the cadavers and six (5%) had accessory hepatic arteries. In five cadavers the accessory hepatic artery followed its course through the fissure for ligamentum venosum, and in one it coursed adjacent to the hepatic artery through the margin of the lesser omentum. One cadaver had a single side branch, which provided arterial blood supply to the left adrenal gland in the absence of any left inferior phrenic artery. Conclusion: Accessory hepatic artery most often follows the course of the hepatic fissure for ligamentum venosum. Albeit uncommonly found in 5% of cases, this finding should be identified during open and endovascular procedures to prevent inadvertent injury.

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7

Singh, Rajani. "Hypoplastic Left Lobe of Liver with Accessory Caudate Lobe." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/604513.

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During routine dissection, a liver from a cadaver of a female aged 50 years was observed to have hypoplastic left lobe, and on posterior surface an accessory caudate lobe was present to the left of main caudate lobe. It was separated by well-defined fissure from caudate lobe. The fissure for ligamentum venosum was present to the left of accessory caudate lobe. Porta hepatis was present below the new lobe. Prominent papillary process continued with caudate process which in turn is fused with right lobe of the liver. These developmental anomalies of liver may cause confusion during procedures like biopsy, transplantation, and lobectomies. This knowledge may be of immense use to clinicians for the diagnosis and management of hepatic diseases, morphologists and anatomists for new variant, and to embryologists for new developmental defect.

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8

Imura, Satoru, Mitsuo Shimada, Tohru Utsunomiya, et al. "A modified liver-hanging maneuver focusing on the ligamentum venosum for left hepatic lobectomy." Surgery Today 42, no. 8 (2011): 720–23. http://dx.doi.org/10.1007/s00595-011-0051-2.

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9

Rutkauskas, Saulius, Vytautas Gedrimas, Tomas Čičinskas, Aurimas Savulis, and Algidas Basevičius. "The center of the human porta hepatis." Medicina 44, no. 9 (2008): 694. http://dx.doi.org/10.3390/medicina44090089.

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Majority of interventional procedures are made at the porta hepatis, which has a different location on the visceral surface of the liver. Objective. To describe the location of the porta hepatis in respect of the borders of the visceral surface and separate lobes of the liver. Material and methods. Sixty-four human livers were obtained at autopsy (mean age, 45 years). We chose the point of the crossing of longitudinal and transversal lines of the porta hepatis, which was considered as center of the porta hepatis. The distances from the center of the porta hepatis to the border of the visceral surface every 10 degrees with protractor and ruler and the angles of anatomical structures were measured. Additionally, the borders of lobes were assessed. Results. We found that center of the porta hepatis is located approximately 11.6±2.8 cm from the border of the visceral liver surface. The location of center of the porta hepatis was 11.6±1.1 cm from the border of left lobe, 9.7±1.5 cm from the border of quadrate lobe, 12.3±1.2 cm from the border of right lobe, and 7.4±1.0 cm from the border of caudate lobe. All distances were statistically significant (P<0.05). An angle of the fissure for round ligament was 50.5°, of the fossa of gallbladder – 102°, of the groove of vena cava inferior – 266°, and of the fissure for ligamentum venosum – 293°. The borders of the right, left, quadrate, and caudate liver lobe covered 45.6%, 32.6%, 14.3%, and 7.5% of the perimeter of visceral surface border, respectively. Conclusions. The center of the porta hepatis can help to characterize precisely the position of the porta hepatis on the visceral surface of the liver.

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10

Kogure, Kimitaka, Masatoshi Ishizaki, Masaaki Nemoto, et al. "Morphogenesis of an anomalous ligamentum venosum terminating in the superior left hepatic vein in a human liver." Journal of Hepato-Biliary-Pancreatic Surgery 12, no. 4 (2005): 310–13. http://dx.doi.org/10.1007/s00534-005-0987-y.

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Hur, Mi-Sun, Ho-Jeong Kim, and Kyu-Seok Lee. "Termination of the ligamentum venosum and the topographic relationship between the left portal vein, left hepatic artery, and ligamentum venosum in the fissures for the ligamentum teres and ligamentum venosum." Surgical and Radiologic Anatomy 37, no. 5 (2014): 449–55. http://dx.doi.org/10.1007/s00276-014-1367-6.

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12

Srinivas, G., D.V. Ramanjaneyulu, E. Muralinath, et al. "A Peculiar Parameters of Physiology Newborn Include An Involvement of Organ Systems such as Changes In Fetal Circulation at Birth, Pulmonary System, Haematological System, Metabolism as well as Thermoregulation and Pathophysiology." Journal of Advancement in Immunology 2, no. 1 (2025): 10–17. https://doi.org/10.5281/zenodo.15321628.

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<em>Newborns have unique and complex physiologies because they change over the period of minutes, hours, days, and months. After reaching maturity, a person's physiology remains constant and predictable; any deviation raises the possibility of disease and sickness. Whatever it is, the physiology of a baby reacts quickly and constantly to the environment outside the womb. This page explains the important physiology related to the newborn era so that readers may better understand the complexities of this stage of life.</em>

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13

Djukic, Vladimir, Aleksandar Karamarkovic, Dejan Radenkovic, et al. "Hanging manuever in liver trauma." Acta chirurgica Iugoslavica 57, no. 4 (2010): 53–56. http://dx.doi.org/10.2298/aci1004053d.

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The philosophy of aggressive surgical approach, its complete implementation in liver trauma surgery did not appear efficient. No matter of permanenent development of diagnostic imaging methods, anesthesia, intensive therapy, medical technology and suture materials, operational theater and operative techniques, major liver resections in trauma had mortality rate up to 60%. With introduction of computerized tomography ( CT,1981) in everyday clinical praxis and with better evaluation of trauma patients, the whole approach to liver trauma patient has been redesigned. Based on AAST - OIS classification, almost 70% of traumatized with grade I,II and III should be treated non - operatively, hospitally, with repeating FAST (focused abdominal ultrasound in trauma) and abdominal CT scans. The rest of traumatized patients, with grade IV and V injuries of juxtahepatic structures demand complexive surgical treatment. The modalities of surgical treatment depend on trauma mechanisms, extensivity, anatomical localization and affection of vascular structures. Hanging Manuevr- the Method of French surgeon Belghiti bases on anterior approach in liver resection is a try for fast solution for fatal bleeding in liver trauma. It consists of placing the elastic cord throughout the anterior surface of VCI or ligamentum venosusm, of upper end of the cord is located in superior part of VCI where hepatic veins are emerging. Lower end of the cord is located in subhepatic part of VCI between 3 Glisonian pedicles. Concerning hepatic veins liver is divided in 3 sections, which derives blood in right hepatic vein RHV, middle hepatic vein MHV and left hepatic vein LHV. Belghiti proposed the usage of hanging maneuver when resecting the right liver, while the cord is placed throughout retrohepatic VCI, lower end between elements of Glisonian pedicle and upper end between hepatic veins. Complications like bleeding from caudal veins are minimal, then speed in liver resection in hemodynamic unstable and ishemic patient, defects like bleeding because compressing tapes or lesions IVC tile mobilazion of liver for conventional resection.

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Karishma, Shruthi, S. J. Haridarshan, and S. Rajagopalan. "Urachal remnants presenting as an umbilical sinus in middle age: a rare case report." International Surgery Journal 5, no. 1 (2017): 330. http://dx.doi.org/10.18203/2349-2902.isj20175921.

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Urachal sinus is a rare type of Vitello intestinal duct anomalies. Clinical presentation is that of persistent umbilical discharge. It is usually seen in paediatric age group. Moreover, they have a different course in adults than paediatric age group in which they frequently involute and have a benign course. These remnants are prone to infection and development of malignancy. A proper diagnostic workup by clinical and imaging tools is required. Early removal of urachal remnants at first diagnosis is key for preventing future morbidities. In our case, all the three remnants (Vitello intestinal duct, urachus and ligamentum venosum) were found in a middle-aged patient and hence is unusual and a rare presentation.

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15

Sareli, Merab, Ilia Chanukvadze, Adrian Valeanu, Douglas B. Zippel, Ron Shapiro, and Moshe Z. Papa. "The posterior intrahepatic approach to the left portal pedicle using the ligamentum venosum: anatomical basis." Surgical and Radiologic Anatomy 31, no. 10 (2009): 809–13. http://dx.doi.org/10.1007/s00276-009-0530-y.

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16

Muangkaew, Paramin, and Anusak Yiengpruksawan. "Robotic Technique for Accessing Left Hepatic Vein Through Ligamentum Venosum in Left Hepatectomy: How I Do It?" Journal of Laparoendoscopic & Advanced Surgical Techniques 26, no. 9 (2016): 725–29. http://dx.doi.org/10.1089/lap.2016.0282.

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17

Dahmane, Raja, Abdelwaheb Morjane, Dean Ravnik, and Marija Hribernik. "Anatomy of the Ligamentum Venosum Arantii and Its Contribution to the Left Hepatic Vein and Common Trunk Control." Cells Tissues Organs 190, no. 5 (2009): 297–300. http://dx.doi.org/10.1159/000202979.

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18

Ando, Hisami, Takahiko Seo, Fujio Ito, et al. "A new hepatic portoenterostomy with division of the ligamentum venosum for treatment of biliary atresia: A preliminary report." Journal of Pediatric Surgery 32, no. 11 (1997): 1552–54. http://dx.doi.org/10.1016/s0022-3468(97)90450-4.

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19

Kim, Ji Hoon. "Usefulness of the Ligamentum Venosum as an Anatomical Landmark for Safe Laparoscopic Left Hepatectomy (How I Do It)." Journal of Gastrointestinal Surgery 22, no. 8 (2018): 1464–69. http://dx.doi.org/10.1007/s11605-018-3757-2.

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Higashi, Hisanobu, Yuta Abe, Kodai Abe, et al. "Novel procedure for hepatic venous outflow block after liver resection: A case report." World Journal of Clinical Cases 12, no. 29 (2024): 6320–26. http://dx.doi.org/10.12998/wjcc.v12.i29.6320.

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BACKGROUND Postoperative complications like remnant hepatic vein (HV) outflow block and liver torsion can occur after right hepatectomy. Hepatic falciform ligament fixation is typically used to prevent liver torsion. We report a novel procedure to manage outflow block. CASE SUMMARY An 80-year-old man developed HV outflow block after remnant right hepatectomy, despite liver fixation and intraoperative HV flow check. He had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and choledojejunostomy. The falciform ligament fixation was inadequate to maintain liver position. Emergency surgery was performed, using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal adhesion. His postoperative course was uneventful. CONCLUSION This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.

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Tomaszewski, Maria-Magdalene, J. Todd Kuenster, and Kip Hartman. "Leiomyosarcoma of Ligamentum Teres of Liver: Case Report." Pediatric Pathology 5, no. 2 (1986): 147–56. http://dx.doi.org/10.3109/15513818609041197.

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22

Cawich, Shamir O., Michael T. Gardner, Ramnanand Shetty, et al. "Human liver umbilical fissure variants: pons hepatis (ligamentum teres tunnel)." Surgical and Radiologic Anatomy 43, no. 5 (2021): 795–803. http://dx.doi.org/10.1007/s00276-021-02688-8.

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23

Anisimov, A. Yu, A. A. Anisimov, A. I. Andreev, R. A. Ibragimov, and A. T. Garaev. "First Clinical Experience of Venous Reconstruction With Autologous Vascular Prosthesis From the Sickle Ligament of the Liver With Partial Portosystemic Bypass Surgery." Russian Sklifosovsky Journal "Emergency Medical Care" 10, no. 3 (2021): 589–97. http://dx.doi.org/10.23934/2223-9022-2021-10-3-589-597.

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Aim of study. Presentation of our own first clinical experience of venous reconstruction in portosystemic bypass surgery with the use of autologous vascular prostheses of the falciform ligament of the liver in the splenorenal position in a patient with portal hypertension syndrome in the outcome of liver cirrhosis of viral etiology.Material and methods. Clinical observation of a patient born in 1978 with a diagnosis of cirrhosis of the liver of viral etiology (HCV) Child-Pugh A (6). MELD 10 points. Inactive phase. Intrahepatic portal hypertension syndrome. Esophageal varices grade III according to A. G. Scherzinger, gastric varices type I (GOV1) according to Sarin. Condition after repeated recurrent esophageal-gastric bleeding. Due to the high risk of another bleeding, as a secondary prevention of esophageal-gastric bleeding, partial splenorenal anastomosis of “H” - type was performed with the use of an autologous vascular prosthesis of the falciform ligament of the liver in the splenorenal position.Results. A flap measuring 60.0x20.0 mm was cut from the falciform ligament of the patient’s liver. From the latter, after adjusting the size of the graft to the individual needs of the patient, an autologous conduit was formed. It was used as an insert in the formation of an “H” - type splenorenal anastomosis with the imposition of two end-to-side anastomoses between the splenic vein and one end of the conduit and between the left renal vein and the other end of the conduit. The patency of the anastomosis was checked using intraoperative sonography. In a satisfactory condition, the patient was discharged for outpatient follow-up treatment at the place of residence. At the moment of writing the article, the follow-up period was 8 months. The bleeding did not recur. No varicose veins were found in the esophagus and stomach during control endoscopic examinations. The patency of the splenorenal shunt was confirmed by ultrasound dopplerography.Conclusion. The first clinical experience of venous reconstruction with portosystemic bypass surgery using as a possible replacement of autologous vascular prostheses of the falciform ligament of the liver in the splenorenal position in a patient with portal hypertension syndrome in the outcome of cirrhosis of the liver of viral etiology gives hope for the possibility of further successful testing of this method of splenorenal bypass surgery to reduce the risk of bleeding from varicose veins.

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24

Shrestha, Sunil, Nitasha Sharma, and Ajay Shah. "Ligamentum Teres Hepatis Tunnel (Pons hepatis) in Human Liver: A Case Report from Nepal." Journal of Universal College of Medical Sciences 11, no. 03 (2023): 67–69. http://dx.doi.org/10.3126/jucms.v11i03.61617.

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INTRODUCTION The liver, the biggest gland with diverse metabolic activity consist right and left lobe, where left lobe was isolated from quadrate lobe by umbilical or ﬁssure for ligamentum teres exhibits variation. The case reported explains about the liver tissue bridge, a 2 cm long creating incomplete tunnel that connect the quadrate lobe to the left lobe corresponding to type 4 b variation of Pons hepatis. As a result, the tunnel may depict a deceptive impression of a diseased cavity due to liver parenchyma and confuse surgeons and pathologist.

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Runkel, Mira, Jasmina Kuvendjiska, Goran Marjanovic, Stefan Fichtner-Feigl, and Markus K. Diener. "Ligamentum teres augmentation (LTA) for hiatal hernia repair after minimally invasive esophageal resection: a new use for an old structure." Langenbeck's Archives of Surgery 406, no. 7 (2021): 2521–25. http://dx.doi.org/10.1007/s00423-021-02284-9.

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Abstract Purpose Hiatal hernias with intrathoracic migration of the intestines are serious complications after minimally invasive esophageal resection with gastric sleeve conduit. High recurrence rates have been reported for standard suture hiatoplasties. Additional mesh reinforcement is not generally recommended due to the serious risk of endangering the gastric sleeve. We propose a safe, simple, and effective method to close the hiatal defect with the ligamentum teres. Methods After laparoscopic repositioning the migrated intestines, the ligamentum teres is dissected from the ligamentum falciforme and the anterior abdominal wall. It is then positioned behind the left lobe of the liver and swung toward the hiatal orifice. Across the anterior aspect of the hiatal defect it is semi-circularly fixated with non-absorbable sutures. Care should be taken not to endanger the blood supply of the gastric sleeve. Results We have used this technique for a total of 6 patients with hiatal hernias after hybrid minimally invasive esophageal resection in the elective (n = 4) and emergency setting (n = 2). No intraoperative or postoperative complications have been observed. No recurrence has been reported for 3 patients after 3 months. Conclusion Primary suture hiatoplasties for hiatal hernias after minimally invasive esophageal resection can be technically challenging, and high postoperative recurrence rates are reported. An alternative, safe method is needed to close the hiatal defect. Our promising preliminary experience should stimulate further studies regarding the durability and efficacy of using the ligamentum teres hepatis to cover the hiatal defect.

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Interventional Radiology, Malaysian Society of. "MYSIR's Abstracts 2." Interventionalist Journal 2, no. 4 (2022): 25–30. http://dx.doi.org/10.32896/tij.v2n4.25-30.

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MYSIR’s Abstracts 2 1. EP01: A RARE CASE OF POST MVA CERVICAL LIGAMENTOUS TEAR COMPLICATED WITH VERTEBRAL ARTERIOVENOUS FISTULA (VAVF) WITH SUCCESSFUL ENDOVASCULAR TREATMENT 2. EP02: SIGNIFICANTLY LESS BLEEDING INTRAOPERATIVELY WITH FAVORABLE POST-SURGICAL OUTCOMES FOLLOWING ENDOVASCULAR COILING AND AMPLATZER VASCULAR PLUG FOR AURICULAR ARTERIO-VENOUS MALFORMATION 3. EP03: POSTERIOR TRANSGLUTEAL CT FLUOROSCOPY GUIDED PERCUTANEOUS DRAINAGE OF DEEP PELVIC ABSCESS IN SULTAN HAJI AHMAD SHAH MEDICAL CENTRE @IIUM (SASMEC @IIUM): A CASE SERIES 4. EP04: PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE IN ADULT BILIARY ATRESIA WITH NATIVE LIVER: A CASE SERIES 5. EP05: MAY-THURNER SYNDROME CONUNDRUM: MASSIVE SUBCAPSULAR LIVER HEMATOMA FOLLOWING INTRAVENOUS THROMBOLYSIS FOR DEEP VEIN THROMBOSIS 6. EP06: FIRST SUCCESSFUL TRANSCHOLECYSTO-CYSTIC DUCT COMMON BILE DUCT STENTING IN A CASE OF MALIGNANT OBSTRUCTIVE JAUNDICE

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Lee, Jae Young, Jin Wook Chung, Tae Kyung Kim, Seung Whi Cho, Jeong Yeon Cho, and Jae Hyung Park. "Diagnosis of Normal Variation of Hepatic Artery on Axial Image of Spiral CT: Importance of a vascular structure in a portocaval space and fissure of ligamentum venosum." Journal of the Korean Radiological Society 37, no. 3 (1997): 473. http://dx.doi.org/10.3348/jkrs.1997.37.3.473.

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Lagoudianakis, Emmanuel E., Nikolaos Michalopoulos, Haridimos Markogiannakis, et al. "A symptomatic cyst of the ligamentum teres of the liver: A case report." World Journal of Gastroenterology 14, no. 20 (2008): 3266. http://dx.doi.org/10.3748/wjg.14.3266.

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Nilsson, A., P. Å. Olofsson, I. Lorén, and P. Nilsson. "Colour doppler imaging of shunts from the left portal branch in portal hypertension." Acta Radiologica 39, no. 5 (1998): 564–67. http://dx.doi.org/10.1080/02841859809172226.

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Purpose: to describe the typical colour Doppler appearance of a shunt through the parenchyma of the left lobe of the liver in portal hypertension Material and Methods: Ultrasound images of 141 patients with biopsy-verified cirrhosis were reviewed. Special note was taken of the appearance of shunts from the left portal branch Results: in 28 patients, shunts from the left portal branch were detected ultra-sonographically, 10 of which ran through the liver parenchyma on a course separated from the ligamentum teres. Seven of these 10 followed a tortuous course just below the surface of the liver creating a ball or corkscrew-like pattern Conclusion: Shunts from the left portal branch are not uncommon and may represent the only ultrasonographically detectable pathology in these patients. Recognition of the typical pattern will facilitate their detection

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30

Mansur, Dil Islam, P. Shrestha, and S. Maskey. "Morphological Variations in Human Liver: A Cadaveric Study." Nepal Medical College Journal 21, no. 4 (2019): 249–53. http://dx.doi.org/10.3126/nmcj.v21i4.27612.

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The variations of liver like the accessory fissures and lobes are a potential source of diagnostic errors. The knowledge in the variations may help in diagnosis, treatment planning and minimize the risk of post operative complications. The present study was aimed to observe the morphological variations of livers. The study was done in 70 formalin fixed human livers and was observed for morphological variations. The present study concluded the normal morphology of liver was in 54.28% and anomalies in 45.71% of liver. The most common anomalies were accessory fissures which were found in 32.86% of livers. The second common anomalies were absence or incomplete fissure for ligamentum teres in 15.71% of livers. Then the enlarged papillary process was found in 11.43%, short gall bladder was in 10% and elongated left lobe was in 7.14%. The knowledge of normal and variant liver may contribute to the understanding of the liver disease and to achieve correct preoperative diagnosis; and to avoid intra-operative complications.

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Gupta, Arpita, Jasbir Kaur, Hitendra Loh, Rashmoni Jana, R. K. Suri, and Vandana Mehta. "Abnormal peritoneal folds with incomplete fissure for ligamentum teres in liver – a case report." Journal of the Anatomical Society of India 66 (August 2017): S81. http://dx.doi.org/10.1016/j.jasi.2017.08.255.

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TSUKUI, Hidenori, Yasunaru SAKUMA, Hideki SASANUMA, Hisanaga HORIE, Yoshikazu YASUDA, and Naohiro SATA. "A Case of Bile Duct Cancer with a Right-sided Ligamentum Teres of the Liver." Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 76, no. 10 (2015): 2532–37. http://dx.doi.org/10.3919/jjsa.76.2532.

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Ji, Zixiang, Zhenyu Wang, and Hao Li. "Abscess of ligamentum teres hepatis post-endoscopic retrograde cholangiopancreatography: A case report and a literature review." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2211109. http://dx.doi.org/10.1177/2050313x221110994.

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Abscess of the ligamentum teres hepatis has been described in the medical literature as an extremely rare clinical entity, which often presents a diagnostic dilemma. A 68-year-old man was hospitalized for upper abdominal pain and obstructive jaundice. The patient presented with low-grade intermittent fever. Laboratory investigations showed a white blood cell count of 32.38 × 109/L, a C-reactive protein level of 247.86 mg/L, abnormal liver enzyme and bilirubin levels, and elevated serum levels of amylase and lipase. He was first diagnosed with acute biliary pancreatitis. A computational tomography scan and magnetic resonance cholangiopancreatography revealed obstructive choledocholithiasis and cholecystolithiasis. The patient received preoperative antibiotics and symptomatic treatments for 5 days, followed by endoscopic retrograde cholangiopancreatography and a subsequent duodenal papilla incision to extract pigment and cholesterol gallstones. The patient recovered and was discharged on the fifth day after surgery. However, 10 days later, the patient was readmitted for the recurrence of acute calculous cholecystitis. Laboratory tests showed increases in total and direct bilirubin, γ-glutamyltransferase, and alkaline phosphatase, but not inflammatory parameters. After the patient’s nutritional status improved on the 11th day after admission, a laparoscopic cholecystectomy was performed. Intraoperative exploration revealed extensive abdominal adhesions; a thickened edematous gallbladder wall; and an unexpected abscess of the ligamentum teres hepatis. Pus aspiration was performed laparoscopically after laparoscopic cholecystectomy, and to ensure elimination of the abscess, ultrasound-guided pus aspiration was also performed 1 week later. Fortunately, the patient made an uneventful recovery and was discharged with a drain tube on the 16th day after surgery. Doppler ultrasound indicated that the abscess had completely disappeared 2 weeks after discharge. This case highlights an unusual presentation of a ligamentum teres hepatis abscess caused by obstructive cholangitis but that appeared after the choledocholithiasis was resolved. However, the mechanism of abscess formation remained uncertain.

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Na, Ying, Xiang-Dong Liu, and Hui-Min Xu. "Differential diagnosis of gastric submucosal masses and external pressure lesions." World Journal of Gastrointestinal Surgery 16, no. 10 (2024): 3374–76. http://dx.doi.org/10.4240/wjgs.v16.i10.3374.

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Lesions of the left triangular ligament of the liver are rare, and there are even fewer cases of vascular tumors misdiagnosed as gastrointestinal stromal tumors. We comment on the two cases reported in the article. The article did not include pictures of laparoscopic surgery, making it unconvincing. For gastric submucosal lesions, enhanced computed tomography venous phase imaging may be beneficial for differential diagnosis. Although endoscopic ultrasound is an effective tool for diagnosing submucosal lesions of the stomach, due to various factors, it cannot achieve an accurate diagnosis. During endoscopic examination, a more accurate diagnosis can be made depending on the personal experience of the operators.

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Slobodian, O., and O. Zabrodska. "TOPOGRAPHY FORMATION OF THE UMBILICAL VEIN IN PREFETUS." Clinical anatomy and operative surgery 20, no. 2 (2021): 35–41. http://dx.doi.org/10.24061/1727-0847.20.2.2021.16.

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Venous blood ﬂ ow in the liver is unique because it is provided by two embryonic and functionally diﬀ erent systems: the umbilical and portal hepatic or yolk systems.The largest tributary vessel of the liver in pre-fetuses is the umbilical vein (UV), which passes through the gap of the round ligament of the liver and gives from 2 to 5 branches to the left side of the liver and the same number to the square. At the level of the left edge of the transverse sulcus, the UV is divided into three termin branches: the posterior branch to the left lobe, the venous (Arantian) duct, and the anastomotic branch, through which the UV connects to the portal hepatic vein (PHV).To study the patterns and identify the features of the intrahepatic topography of venous structures, in particular the umbilical vein in the prefetal period of human ontogenesis.For the study, 50 objects of pre-fetuses were used. To achieve this goal, a complex of morphological research methods was used, including the method of morphometry, the production and study of a series of histological sections, macro- and microscopy, conventional and ﬁ ne preparation under the control of an MBS-10 microscope, injection of vessels with the following radiography.At the beginning of the prefetal period of development (VII week), the liver occupies the cranioventral and middle sections of the abdominal cavity. Its transverse dimension is 4.8 mm (pre-fetus 19.8 mm of parietalcoccygeal length (PCL)) and 5.1 mm (pre-fetus 20.0 mm PCL).UV of pre-fetuses of the 7th week of development (14.0-20.0 mm PCL) was studied on 16 series of histological sections. It enters the liver in the area of the anterior edge of the left sagittal groove and is covered from below by the liver tissue. Along the way, it gives oﬀ 2-3 left side branches with a diameter of 40-50 microns, branching in the left lobe of the organ, and 1-2 right ones, entering the square lobe. The UV enters the liver parenchyma in the area of the anterior edge of the left sagittal sulcus and passes in the anterior- posterior direction within its anterior part. From below, the vein is covered with liver tissue.The outer diameter of the UV at the edge of the liver is 370 μm (pre-fetus 30.0 mm PCL), its length reaches 940 μm.In the course of the UV, it gives oﬀ 2-3 left lateral branches with a diameter of 98-102 microns, branching in the left lobe of the liver, within the future II, III and partially I and IV segments, and 1-2 right ones, entering the square lobe, ending in the future IV segment.Consequently, at the end of the prefetal period of development, the intrahepatic topography of the aﬀ erent venous vessels (umbilical and portal veins) and their branches of 1-2 orders acquires certain features of the deﬁ nitive one.

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Hai, Seikan, Etsuro Hatano, Tadamichi Hirano, et al. "Hepatectomy for Hilar Cholangiocarcinoma with Right-Sided Ligamentum Teres Using a Hepatectomy Simulation System." Case Reports in Gastroenterology 11, no. 3 (2017): 576–83. http://dx.doi.org/10.1159/000480375.

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Right-sided ligamentum teres (RSLT) is a rare congenital anomaly often accompanied by variation of the hepatic vasculature. We herein report a surgical case of a hilar cholangiocarcinoma with RSLT in whom preoperative hepatectomy simulation proved useful for understanding the anatomical structure of the liver. A 78-year-old male with obstructive jaundice was referred to our department for further examination. The patient was suspected of having a hilar cholangiocarcinoma originating from the left hepatic bile duct by contrast-enhanced computed tomography (CT), and CT also showed right umbilical portion (RUP). Three-dimensional images of the hepatic vasculature and biliary system reconstructed using a hepatectomy simulation system suggested that all portal branches ramified from RUP were right paramedian branches, and three leftward portal branches from these ran parallel to the peripheral bile ducts confluent with the left hepatic bile duct, where the tumor was present. Hepatic resection of part of the ventral area of the right paramedian sector and left hemiliver was performed along the demarcation line drawn after clamping the portal branches; the ratio of estimated liver resection volume was 28.9%. After the operation, bile leakage occurred. However, the leakage was treated with percutaneous drainage alone, and the patient was discharged 77 days after the operation. The patient is doing well without any signs of recurrence 21 months after the operation. The vascular and biliary anatomy in patients with RSLT is complicated and should be evaluated in detail preoperatively using a hepatectomy simulation system.

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Ikegami, Toru, Huanlin Wang, Daisuke Imai, et al. "Pathological analysis of opened round ligaments as venous patch grafts in living donor liver transplantation." Liver Transplantation 19, no. 11 (2013): 1245–51. http://dx.doi.org/10.1002/lt.23716.

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Lucas, Charles E. "The Evolution of Liver Injury Diagnosis and Treatment in the Past 50 Years." Panamerican Journal of Trauma, Critical Care & Emergency Surgery 3, no. 3 (2014): 124–31. http://dx.doi.org/10.5005/jp-journals-10030-1103.

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ABSTRACT Background During the past 50 years many changes have occurred in treating liver injury. Nonoperative therapy (NOT) for blunt penetrating injuries is now common. Study design This report highlights the current therapy of liver injury. Results Complications of NOT include early rebleeding requiring prompt operative intervention; intrahepatic hematoma which becomes infected necessitating drainage; bile peritoneum requiring exploration and drainage; and hemobilia requiring embolization, hepatotomy with ligation, or resection. Operative exposure through a midline incision which can be extended as a median sternotomy is preferred. Prehepatic and intrahepatic packs are helpful. Full mobilization of the right and left triangular ligaments augments exposure. Hemostasis for both blunt and penetrating, usually, is obtained by hepatorrhaphy using the 2’ blunt tipped needle swedged onto a 2-O chromic suture. Through-and-through injuries may require hepatotomy with intrahepatic ligation of cross-linking vessels. Locally destructive wounds may require nonanatomic debridement to the point of healthy liver tissue which is then sutured. Formal segmentectomy, or lobectomy, is seldom needed. Hepatic artery ligation controls deep arterial not involving the portal venous supply. The retrohepatic caval atrial shunt will facilitate hemostasis from central liver injuries involving the hepatic veins or retrohepatic cava. Debridement of emacerated liver tissue should be extended to good liver parenchyma where deep liver sutures help with approximate the edges. Drainage is not used for minor injuries. Closed suctions are best for larger wounds. Common duct drainage should be avoided. Conclusion Most liver injuries are treated by NOT. Operative therapy involves hemostasis, debridement when necessary, and selective drainage. How to cite this article Lucas CE. The Evolution of Liver Injury Diagnosis and Treatment in the Past 50 Years. Panam J Trauma Crit Care Emerg Surg 2014;3(3):124-131.

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Swami, Nand Prasad, Madhu Nimisha, and Prasad Rajendra. "An Additional (Accessory) Lobe of Liver and its Clinical Significance: Cadaveric Study." International Journal of Pharmaceutical and Clinical Research 14, no. 2 (2022): 108–11. https://doi.org/10.5281/zenodo.13854692.

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<strong>Aim:</strong> Cadaveric study of an accessory lobe of liver and its clinical significance. <strong>Methods: </strong>This observational study was carried out in the Department of Anatomy, Anugrah Narayan Magadh Medical College, Gaya, Bihar, India for 1 year. 60 adult human livers were obtained from donated embalmed cadavers (50 male & 10 female) in the Department of Anatomy. All of them were found between 64 to 74 years of age. Only cadavers, whose clinical history excluded liver diseases, were used for the study. <strong>Results: </strong>We observed an accessory lobe in 6 livers. They were situated in the posterior part of the fissure for ligamentum teres, close to the porta hepatis. The lobes were triangular in shape and about one inch in width. They were attached to the left anatomical lobe of the liver through a vascular pedicle which contained the branches of hepatic artery, portal vein and hepatic duct. Microscopic structure of the accessory lobe showed normal liver architecture. <strong>Conclusion: </strong>Knowledge of the presence of a small accessory lobe of the liver near the porta hepatis is useful for surgeons and radiologists in diagnosing, surgical planning and avoiding iatrogenic injuries of the accessory lobe.      

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Ribeiro, Luis, Saissan Rajendran, Katherine Stenson, and Ian Loftus. "Rare case of a proximal descending thoracic aorta mycotic aneurysm following intravesical BCG injections for the treatment of bladder cancer." BMJ Case Reports 12, no. 12 (2019): e231595. http://dx.doi.org/10.1136/bcr-2019-231595.

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A 79-year-old man presented with an enlarging thoracic aneurysm on the background of superficial bladder cancer treated with intravesical bacillus Calmette-Guérin (BCG) injections. Following the injections, he developed deranged liver function tests and hepatomegaly. Liver biopsy revealed granulomatous hepatitis compatible with disseminated mycobacterial infection (BCG-osis) and was treated with anti-tuberculosis agents for 12 months. A surveillance CT scan performed as a follow-up for his bladder cancer in 2018 revealed a saccular thoracic aneurysm at the ligamentum arteriosum, which was metabolically active on positron emission tomography (PET) scan. Given the timeframe from intravesical instillation of BCG and the metabolic activity on PET scan, the lesion was consistent with a mycotic aneurysm secondary to disseminated mycobacterial infection. Following multidisciplinary team discussion, a thoracic endovascular aneurysm repair was performed. The stent grafts were placed distal to the left subclavian artery with good angiographic results and no immediate postoperative complications. He was initiated on long-term antibiotics to cover potential bacterial pathogens including mycobacterium.

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Usuda, Daisuke, Kento Takeshima, Ryusho Sangen, et al. "Atypical lipomatous tumor in the ligamentum teres of liver: A case report and review of the literature." World Journal of Clinical Cases 6, no. 12 (2018): 548–53. http://dx.doi.org/10.12998/wjcc.v6.i12.548.

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Toshima, Takeo, Toru Ikegami, Yoshihiro Matsumoto, et al. "One-step venous reconstruction using the donor’s round ligament in right-lobe living-donor liver transplantation." Surgery Today 45, no. 4 (2014): 522–25. http://dx.doi.org/10.1007/s00595-014-1004-3.

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43

Nechifor-Boila, IA, H. Suciu, Loghin Andrada, et al. "Piggy-back Hepatic Transplant Technique and Veno-venous Bypass Without Cardiac Arrest: A Multidisciplinary Approach in Borderline T3b/T3c Renal Tumors." Acta Medica Marisiensis 61, no. 2 (2015): 132–35. http://dx.doi.org/10.1515/amma-2015-0038.

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Abstract Surgery for renal cell carcinomas with tumor thrombus extending in the Inferior Vena Cava (IVC) can be particularly challenging, especially in the retrohepatic and intraatrial situations (T3b and T3c). Classically, these tumors require the intraoperative use of cardio-pulmonary by-pass (CPB) and deep hypothermic circulatory arrest (DHCA), that can result in specific complications (stroke, platelet dysfunction), with increased postoperative morbidity rates. In urological practice, a particular IVC preparation method is currently in use, allowing full control both upon the IVC and its tributaries. It is derived from the “piggy-back” liver transplantation technique and implies the resection of all hepatic ligaments, leaving the hepatic vascular connections intact. This procedure is joined by a form of veno-venous bypass (between the right atrium and the infrarenal IVC) that allows a constant central venous pressure (by assuring blood return), with less bleeding and without the need for CPB and DHCA (avoiding, in this way, their inherent complications). All in all, these recently-introduced procedures can offer better thrombus control, improved oncologic outcomes and smaller complication rates. We aim to present a case of borderline T3b/T3c renal tumor that was successfully treated in our university center using these techniques.

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Yamagami, T., T. Nakamura, and T. Maeda. "Aberrant gastric venous inflow to the left lobe of the liver parenchyma adjacent to the falciform ligament." British Journal of Radiology 72, no. 861 (1999): 903–5. http://dx.doi.org/10.1259/bjr.72.861.10645200.

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45

Czigany, Zoltan, Koichiro Hata, Wei Lai, et al. "A Dual Protective Effect of Intestinal Remote Ischemic Conditioning in a Rat Model of Total Hepatic Ischemia." Journal of Clinical Medicine 8, no. 10 (2019): 1546. http://dx.doi.org/10.3390/jcm8101546.

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The present study aimed to investigate the effects of intestinal remote ischemic preconditioning (iRIC) on ischemia-reperfusion injury (IRI) and gut barrier integrity in a rat model of total hepatic ischemia (THI). Male Wistar rats (n = 50; 250–300 g) were randomly allocated into two experimental groups: RIC/Control. Thirty minutes of THI was induced by clamping the hepatoduodenal ligament. iRIC was applied as 4-min of ischemia followed by 11-min of reperfusion by clamping the superior mesenteric artery. Animals were sacrificed at 1, 2, 6, 24 h post-reperfusion (n = 5/group/timepoint). RIC of the gut significantly improved microcirculation of the ileum and the liver. Tissue ATP-levels were higher following iRIC (Liver: 1.34 ± 0.12 vs. 0.97 ± 0.20 μmol/g, p = 0.04) and hepatocellular injury was reduced significantly (ALT: 2409 ± 447 vs. 6613 ± 1117 IU/L, p = 0.003). Systemic- and portal venous IL-6 and TNF-alpha levels were markedly lower following iRIC, demonstrating a reduced inflammatory response. iRIC led to a structural and functional preservation of the intestinal barrier. These results suggest that iRIC might confer a potent protection against the detrimental effects of THI in rats via reducing IRI and systemic inflammatory responses and at the same time by mitigating the dramatic consequences of severe intestinal congestion and bacterial translocation.

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46

Tanaka, Tomoko, Takeshi Iwasaki, Atsushi Takebe, et al. "Usefulness of Preoperative CT Simulation for Anatomical Hepatectomy of Liver Metastases in a Patient with Right Sided Ligamentum Teres." Japanese Journal of Gastroenterological Surgery 50, no. 1 (2017): 18–25. http://dx.doi.org/10.5833/jjgs.2016.0045.

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Dr., Simi. C. P., Uma B. Gopal Dr., SurendraChaudhary Dr., Manu Krishnan Dr., DaiarisaRymbai Dr., and Muteebanaz Dr. "Pons Hepatis of Quadrate Lobe A Morphogical Variation of Liver." International Journal of Trend in Scientific Research and Development 4, no. 2 (2020): 107–9. https://doi.org/10.5281/zenodo.3842975.

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Variations of the liver are mostly encountered related to its shape, number of lobes and the patterns of ligaments attached Variations related to fissures and vascular supplies are less common. An anatomical variation was observed during routine dissection of a 60 year old male cadaver at Department of Rachana Sharir, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital. The fissure for ligamentum teres was incomplete which usually extends from inferior border of liver upto a portahepatis. Foramen was created in the inferior surface of liver near to inferior border between quadrate lobe and left lobe of liver . It was passing through the foramina along a tunnel formed by the bridging of hepatic parenchyma in between quadrate lobe and portahepatis and opened at to left border of portahepatis. As a result of parenchymatous bridging, the fissure was absent and so, there was no demarcation of quadrate lobe from the inferior surface of left lobe. The left lobe was extending beyond the left lateral vertical plane. Awareness of such type of anatomical variation can be utilized by anatomists, embryologists, radiologists and surgeons for academic interest, to avoid possible errors in interpretation and subsequent misdiagnosis, and to assist in planning an appropriate surgical approach that is crucial for determining the patient outcome. Dr. Simi. C. P | Dr. Uma B. Gopal | Dr. SurendraChaudhary | Dr. Muteebanaz | Dr. DaiarisaRymbai | Dr. Manu Krishnan "Pons Hepatis of Quadrate Lobe- A Morphogical Variation of Liver" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020, URL: https://www.ijtsrd.com/papers/ijtsrd29870.pdf

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Manakov, A. M., and S. M. Zavaleeva. "Morphological and Morphometric Parameters of the Liver of Newborn Male Rabbits Alexander." Russian Journal of Veterinary Pathology 23, no. 3 (2024): 41–48. http://dx.doi.org/10.23947/2949-4826-2024-23-3-41-48.

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Introduction. At present, the study of age-related issues of the liver structure in animals is one of the most important objectives of morphology, since liver diseases occupy one of the leading places among the nosologies causing death of newborn animals, in particular rabbits. At the same time, although the data on the micromorphological structure of the digestive tract of rabbits is extensive, the data on the age-related anatomy of the liver in the animals under study is scarce in the available literature. The aim of the paper is to determine the morphofunctional features of the liver of newborn male rabbits.Materials and Methods. The objects of the study were newborn male rabbits of the “butterfly” breed (n=9), who had no deviations in development and constitution. To establish the anatomical and topographic features and morphometric parameters of the liver of the animals under study, the standard anatomical dissection, Pirogov's cuts, macromorphometric and statistical research methods were used.Results. It has been established that the liver of newborn male rabbits of “butterfly” breed has segmental nature, the caudate process is large, distinct from the other lobes. The papillary process is oval in shape, poorly developed, adjacent to the lesser curvature of the stomach. The quadrate and right lobes of the liver are well developed, and the left lobes are less developed, which entails the horizontal position of the organ. The ligamentous attachments of the liver are well developed. A round ligament of liver (ligamentum teres hepatis) with fetal hepatic vessels can be distinguished. The linear and weight parameters of the liver are characterised by the small absolute and large relative values. The liver index is inversely proportional to the body weight of an animal and is 5.91.Discussion and Conclusion. The obtained morphological and morphometric data is aimed at establishing the standard liver parameters of the clinically healthy newborn male rabbits of the “butterfly” breed. The liver boundaries have been defined taking into account the length, width, thickness parameters of each lobe separately. The organ topography has been defined including the skeletotopy, holotopy and syntopy of the individual lobes and processes of the liver.

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Iyengar, Pratibha, Dan D. DeAngelis, Mark Greenberg, and Glenn Taylor. "Perivascular Epithelioid Cell Tumor of the Orbit: A Case Report and Review of the Literature." Pediatric and Developmental Pathology 8, no. 1 (2005): 98–104. http://dx.doi.org/10.1007/s10024-004-5055-0.

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We present a unique case of a perivascular epithelioid cell tumor (PEComa) in the orbit of a 9-year-old female patient. The entity of PEComas has been described only recently. Characteristic histologic features and an immunohistochemical profile of negativity for epithelial markers and positivity for melanogenesis-related markers define the tumors. In children and young adults, this tumor has a predilection for the falciform ligament and ligamentum teres of the liver. It is associated with, but not exclusive to, tuberous sclerosis. To the best of our knowledge, this is the first reported case of a PEComa of the orbit in a child or adult. The main differential diagnoses for this melanin pigment-producing lesion include melanoma and pigmented paraganglioma. The histologic features, immunohistochemical profile, ultra-structural studies, and molecular studies led us to favor a diagnosis of PEComa. The prognosis of this entity is undetermined due largely to the small number of reported cases.

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Sato, Yoshinobu, Hiroshi Oya, Satoshi Yamamoto, et al. "Method for Spontaneous Constriction and Closure of Portocaval Shunt Using a Ligamentum Teres Hepatis in Small-for-Size Graft Liver Transplantation." Transplantation 90, no. 11 (2010): 1200–1203. http://dx.doi.org/10.1097/tp.0b013e3181fa93e0.

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