Morison’s pouch: anatomical review and evaluation of pathologies and disease spread on cross-sectional imaging

Nassar, Sameh; Menias, Christine O.; Nada, Ayman; Blair, Katherine J.; Shaaban, Akram M.; Mellnick, Vincent M.; Gaballah, Ayman H.; Lubner, Meghan G.; Baiomy, Ali; Rohren, Scott A; Elsayes, Khaled M.

doi:10.1007/s00261-020-02597-1

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…It is separated from the anterior right subhepatic space by the transverse mesocolon. The posterior right subhepatic space communicates superiorly with the right subphrenic space, inferiorly with the right paracolic space, and medially with the lesser sac through Winslow's foramen [51][52][53]. Morison's pouch is defined by the following boundaries [51][52][53]:…”

Section: Morison's Pouchmentioning

confidence: 99%

“…Studies suggest that dissection of OB could be omitted in cases of adhesions of Winslow's foramen and the absence of enlarged paraaortic, mesenteric and suprarenal lymph nodes [5,7,13]. The liver area should be carefully evaluated in cases of peritoneal carcinomatosis at the Glisson capsule and PH [51][52][53][54][55][56]58]. The spleen should be always investigated for hilum metastases in the case of transcoelomic dissemination of the omental bursa and the presence of omental cake [5,[67][68][69][70].…”

Section: Primary Debulking Surgery Followed By Chemotherapy or Neoadj...mentioning

confidence: 99%

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Neglected Anatomical Areas in Ovarian Cancer: Significance for Optimal Debulking Surgery

Kostov,

Selçuk,

Watrowski

et al. 2024

Cancers

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Ovarian cancer (OC), the most lethal gynecological malignancy, usually presents in advanced stages. Characterized by peritoneal and lymphatic dissemination, OC necessitates a complex surgical approach usually involving the upper abdomen with the aim of achieving optimal cytoreduction without visible macroscopic disease (R0). Failures in optimal cytoreduction, essential for prognosis, often stem from overlooking anatomical neglected sites that harbor residual tumor. Concealed OC metastases may be found in anatomical locations such as the omental bursa; Morison’s pouch; the base of the round ligament and hepatic bridge; the splenic hilum; and suprarenal, retrocrural, cardiophrenic and inguinal lymph nodes. Hence, mastery of anatomy is crucial, given the necessity for maneuvers like liver mobilization, diaphragmatic peritonectomy and splenectomy, as well as dissection of suprarenal, celiac, and cardiophrenic lymph nodes in most cases. This article provides a meticulous anatomical description of neglected anatomical areas during OC surgery and describes surgical steps essential for the dissection of these “neglected” areas. This knowledge should equip clinicians with the tools needed for safe and complete cytoreduction in OC patients.

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