Round ligament of liver

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Round ligament of liver
Gray1086-liver.PNG
Liver seen from below, with the round ligament labeled at bottom.
Illu liver gallbladder.jpg
Details
Precursor Left umbilical vein
Identifiers
Latin ligamentum teres hepatis
MeSH D000069592
TA98 A05.8.01.015
TA2 5104
FMA 14079
Anatomical terminology

The round ligament of the liver, ligamentum teres or ligamentum teres hepatis is a ligament that forms part of the free edge of the falciform ligament of the liver. It connects the liver to the umbilicus. It is the remnant of the left umbilical vein. The round ligament divides the left part of the liver into medial and lateral sections.

Contents

Structure

The round ligament connects the liver to the umbilicus. [1] It divides the left part of the liver into medial and lateral sections. [2] [3]

Development

The round ligament of the liver is the remnant of the umbilical vein during embryonic development. [1] It only exists in placental mammals. [4] After the child is born, the umbilical vein degenerates to fibrous tissue. [4]

The left portal vein (which gives branches to paraumbilical veins) is connected to the round ligament (ligamentum teres) and ligamentum venosum. [5]

Clinical significance

Portal hypertension

In adulthood, small paraumbilical veins remain in the substance of the ligament. These act as an important portacaval anastomosis in severe portal hypertension, resulting in a caput medusae. [6] [7]

Abscess

Very rarely, the round ligament of the liver may develop an abscess. This usually requires liver surgery to treat. [1]

Landmark

The umbilical vein/round ligament inserts around the umbilicus, and is an important landmark of the inner surface of the anterior abdominal wall. [2]

Additional images

See also

Related Research Articles

<span class="mw-page-title-main">Portal vein</span> Short thick vein formed by the union of the superior mesenteric vein and the splenic vein

The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents. Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins.

<span class="mw-page-title-main">Umbilical vein</span> Vein running from the placenta to the fetus

The umbilical vein is a vein present during fetal development that carries oxygenated blood from the placenta into the growing fetus. The umbilical vein provides convenient access to the central circulation of a neonate for restoration of blood volume and for administration of glucose and drugs.

<span class="mw-page-title-main">Sulcus (morphology)</span> Groove in an organ surface

In biological morphology and anatomy, a sulcus is a furrow or fissure. It may be a groove, natural division, deep furrow, elongated cleft, or tear in the surface of a limb or an organ, most notably on the surface of the brain, but also in the lungs, certain muscles, as well as in bones, and elsewhere. Many sulci are the product of a surface fold or junction, such as in the gums, where they fold around the neck of the tooth.

<span class="mw-page-title-main">Lesser omentum</span> Double layer of peritoneum in the abdomen

The lesser omentum is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach, and to the first part of the duodenum. The lesser omentum is usually divided into these two connecting parts: the hepatogastric ligament, and the hepatoduodenal ligament.

<span class="mw-page-title-main">Internal iliac artery</span> Main artery of the pelvis

The internal iliac artery is the main artery of the pelvis.

<span class="mw-page-title-main">Inferior epigastric artery</span> Blood vessel

In human anatomy, the inferior epigastric artery is an artery that arises from the external iliac artery. It is accompanied by the inferior epigastric vein; inferiorly, these two inferior epigastric vessels together travel within the lateral umbilical fold The inferior epigastric artery then traverses the arcuate line of rectus sheath to enter the rectus sheath, then anastomoses with the superior epigastric artery within the rectus sheath.

<span class="mw-page-title-main">Sacrotuberous ligament</span>

The sacrotuberous ligament is situated at the lower and back part of the pelvis. It is flat, and triangular in form; narrower in the middle than at the ends.

<span class="mw-page-title-main">Falciform ligament</span> Ligament attaching the liver to the front body wall

In human anatomy, the falciform ligament is a ligament that attaches the liver to the front body wall and divides the liver into the left lobe and right lobe. The falciform ligament is a broad and thin fold of peritoneum, its base being directed downward and backward and its apex upward and forward. It droops down from the hilum of the liver.

<span class="mw-page-title-main">Obturator artery</span>

The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen, and, escaping from the pelvic cavity through the obturator canal, it divides into an anterior branch and a posterior branch.

<span class="mw-page-title-main">Ligamentum venosum</span>

The ligamentum venosum, also known as Arantius' ligament, is the fibrous remnant of the ductus venosus of the fetal circulation. Usually, it is attached to the left branch of the portal vein within the porta hepatis. It may be continuous with the round ligament of liver.

<span class="mw-page-title-main">Lateral umbilical fold</span>

The lateral umbilical fold is an elevation of the peritoneum lining the inner/posterior surface of the lower anterior abdominal wall formed by the underlying inferior epigastric artery and inferior epigastric vein which the peritoneum covers. Superiorly, the lateral umbilical fold ends where the vessels reach and enter the rectus sheath at the arcuate line of rectus sheath; in spite of the name, the lateral umbilical folds do not extend as far superiorly as the umbilicus. Inferiorly, it extends to just medial to the deep inguinal ring.

<span class="mw-page-title-main">Porta hepatis</span> Short deep depression on the liver

The porta hepatis or transverse fissure of the liver is a short but deep fissure, about 5 cm long, extending transversely beneath the left portion of the right lobe of the liver, nearer its posterior surface than its anterior border.

<span class="mw-page-title-main">Median umbilical ligament</span> Structure in human anatomy

In human anatomy, the median umbilical ligament is an unpaired midline ligamentous structure upon the lower inner surface of the anterior abdominal wall. It is covered by the median umbilical fold.

<span class="mw-page-title-main">Medial umbilical ligament</span>

The medial umbilical ligament, cord of umbilical artery, or obliterated umbilical artery is a paired structure found in human anatomy. It is on the deep surface of the anterior abdominal wall, and is covered by the medial umbilical folds. It is different from the median umbilical ligament, a structure that represents the remnant of the embryonic urachus.

In the course of the round ligament of the liver, small paraumbilical veins are found which establish an anastomosis between the veins of the anterior abdominal wall and the portal vein, hypogastric, and iliac veins. These veins include Burrow's veins, and the veins of Sappey – superior veins of Sappey and the inferior veins of Sappey.

The paracolic gutters are peritoneal recesses – spaces between the colon and the abdominal wall.

<span class="mw-page-title-main">Left triangular ligament</span>

The left triangular ligament is a large peritoneal fold. It connects the posterior part of the upper surface of the left lobe of the liver to the thoracic diaphragm.

<span class="mw-page-title-main">Liver</span> Vertebrate organ involved in metabolism

The liver is a major metabolic organ only found in vertebrate animals, which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it is located in the right upper quadrant of the abdomen, below the diaphragm and mostly shielded by the lower right rib cage. Its other metabolic roles include carbohydrate metabolism, the production of hormones, conversion and storage of nutrients such as glucose and glycogen, and the decomposition of red blood cells.

<span class="mw-page-title-main">Liver segment</span> An anatomical unit of the liver

A liver segment is one of eight segments of the liver as described in the widely used Couinaud classification in the anatomy of the liver. This system divides the lobes of the liver into eight segments based on a transverse plane through the bifurcation of the main portal vein, arranged in a clockwise manner starting from the caudate lobe.

<span class="mw-page-title-main">Lobes of liver</span> Four gross divisions of the human liver

In human anatomy, the liver is divided grossly into four parts or lobes: the right lobe, the left lobe, the caudate lobe, and the quadrate lobe. Seen from the front – the diaphragmatic surface – the liver is divided into two lobes: the right lobe and the left lobe. Viewed from the underside – the visceral surface – the other two smaller lobes, the caudate lobe and the quadrate lobe, are also visible. The two smaller lobes, the caudate lobe and the quadrate lobe, are known as superficial or accessory lobes, and both are located on the underside of the right lobe.

References

  1. 1 2 3 Sumida, Wataru; Kawashima, Hiroshi; Ishimaru, Tetsuya; Ihara, Yoshiyuki; Kakihara, Tomo; Kato, Reiko; Hayashi, Kentaro; Aoyama, Tomohiro; Omata, Kanako (2019-05-01). "Abscess of ligamentum teres hepatis". Journal of Pediatric Surgery Case Reports. 44: 101198. doi: 10.1016/j.epsc.2019.101198 . ISSN   2213-5766.
  2. 1 2 Standring, Susan (2016). Gray's anatomy: the anatomical basis of clinical practice (41 ed.). Philadelphia: Elsevier. ISBN   978-0-7020-5230-9. OCLC   920806541.
  3. Moore, Keith L.; Dalley II, Arthur F.; Agur, A.M.R. (2014). Clinically oriented anatomy (7 ed.). Philadelphia: Wolters Kluwer Health/Lippincott, Williams, & Wilkins. ISBN   978-1-4511-1945-9. OCLC   813301028.
  4. 1 2 Garbar, Veronica; Newton, Bruce W. (2020), "Anatomy, Abdomen and Pelvis, Falciform Ligament", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   30969680 , retrieved 2021-01-24
  5. Ryan, Stephanie (2011). "2". Anatomy for diagnostic imaging (Third ed.). Elsevier Ltd. p. 195. ISBN   9780702029714.
  6. Foster, R J; Cowell, G W (2015-04-20). "Acute paraumbilical vein recanalization: an unusual complication of acute pancreatitis". BJR Case Reports. 1 (1): 20150021. doi:10.1259/bjrcr.20150021. ISSN   2055-7159. PMC   6159162 . PMID   30363191.
  7. Mostbeck, G. H.; Wittich, G. R.; Herold, C.; Vergesslich, K. A.; Walter, R. M.; Frotz, S.; Sommer, G. (February 1989). "Hemodynamic significance of the paraumbilical vein in portal hypertension: assessment with duplex US". Radiology. 170 (2): 339–342. doi:10.1148/radiology.170.2.2643137. ISSN   0033-8419. PMID   2643137.