Porta hepatis
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At the time the article was created Omar Bashir had no recorded disclosures.
View Omar Bashir's current disclosuresAt the time the article was last revised Raymond Chieng had no financial relationships to ineligible companies to disclose.
View Raymond Chieng's current disclosures- Transverse hepatic fissure
- Transverse hepatic fissures
- Transverse fissure (liver)
The porta hepatis, also known as the transverse hepatic fissure, is a deep fissure in the inferior surface of the liver through which all the neurovascular structures (except hepatic veins) and also hepatic ducts enter or leave the liver 1. It runs in the hepatoduodenal ligament and contains:
common hepatic ducts (anterior to the right)
hepatic artery proper (anterior to the left)
portal vein (posterior to both)
It also transmits the hepatic plexus of autonomic nerves:
sympathetic autonomic fibers to the liver and gallbladder
parasympathetic fibers via the hepatic branch from the celiac plexus (supplied by the vagus nerve)
The arrangement of structures around the porta hepatis can be described by the letter "H". The left limb of the "H" is formed by ligamentum venosum superiorly and ligamentum teres inferiorly. Meanwhile, the right limb is formed by the inferior vena cava (IVC) superiorly and the gall bladder inferiorly. The crossbar of the letter "H" is the porta hepatis where the bile ducts, hepatic arteries, and portal vein enters and exits the region. There are also some nerves and lymphatics in the porta hepatis 5. The area bounded between the gall bladder and ligamentum teres is the quadrate lobe of the liver while the area bound between ligamentum venosum and IVC is the caudate lobe of the liver 5.
From anterior to posterior, these porta hepatis structures lie in the order of duct-artery-vein thus the hepatic ducts are more accessible in surgery. The porta hepatis provides attachment for the lesser omentum. It lies between caudate lobe posteriorly and quadrate lobe anteriorly.
References
- 1. Standring S, Gray H. Gray's anatomy, the anatomical basis of clinical practice. Churchill Livingstone. (2008) ISBN:0443066841. Read it at Google Books - Find it at Amazon
- 2. Sinnatamby, C, & Last, R 1999, Last's Anatomy : Regional And Applied, n.p.: Edinburgh ; New York : Churchill Livingstone, 1999., UNIVERSITY OF MELBOURNE's Catalogue, EBSCOhost
- 3. Yadav. VIVA IN ANATOMY (Vol 2). Jaypee Brothers Medical Publishers (P) Ltd. ISBN:8171797032. Read it at Google Books - Find it at Amazon
- 4. Tirumani SH, Shanbhogue AK, Vikram R et-al. Imaging of the porta hepatis: spectrum of disease. Radiographics. 2014;34 (1): 73-92. doi:10.1148/rg.341125190 - Pubmed citation
- 5. Stephanie Ryan, Michelle McNicholas, Stephen J. Eustace. Anatomy for Diagnostic Imaging. (2011) Page 175. ISBN: 9780702029714 - Google Books
Incoming Links
- Periportal halo (CT/US)
- Hepatocystic triangle
- Order of structures in the porta hepatis (mnemonic)
- Normal radiological reference values
- Hepatic artery proper
- Omentum
- Focal hepatic steatosis
- Left hepatic artery
- Portal vein
- Hepatoduodenal ligament
- Ligamentum venosum
- Alveolar echinococcosis
- Hepatogastric ligament
- Primary hepatic lymphoma
- Focal fatty sparing of the liver
- Triangular cord sign (biliary atresia)
- Umbilical vein
- Right hepatic artery
- Middle hepatic artery
- Common hepatic artery
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