Subphrenic vs. Perinephric Abscess: Anatomic Considerations, Diagnosis and Treatment

Beach, Edward W.; Tynan, James C.

doi:10.1016/s0022-5347(17)67280-x

Cited by 4 publications

(1 citation statement)

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“…The description of six such spaces by Thorek (1947), a logical consequence of the erroneous descriptions of the peritoneal folds repeated in the Anglo-Saxon literature since Barnard (1908), is no longer accepted. In fact there are only four (Beach and Tynan 1955;Boyd 1958Boyd , 1966). …”

Section: Compartmentalisation Of the Subphrenic Spacesmentioning

confidence: 99%

The mechanisms responsible for stabilising the liver

Delattre

Hidden³

1982

Anat. Clin

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Summary. Several factors, both dynamic and static are together responsible for maintaining the position of the liver in the upper part of the abdomen. The fixed anatomical structures are represented essentially by the suspension and tethering of the liver to its vascular pedicle. The inferior vena cava, the particular importance of which was discovered by Faure, suspends the liver by way of the suprahepatic veins. The ligamentum teres, stretched between the inferior vena cava and the anterior abdominal wall, supports the left hepatic lobe.The ligaments of the liver and the peritoneal folds which surround them only play a minimal role in stabilising the liver; on the other hand they are of fundamental importance in dividing off the subdiaphragmatic spaces. Their shape and their effectiveness in stabilising the liver depends on the morphotype of the subject, and they may be looked upon as lateral stabilisers of the liver.Apart from the anatomical structures mentioned above, which are relatively easy to describe and classify, a certain number of other factors are implicated in maintaining fixity of the liver. Of considerable importance is the support that the liver obtains from neighbouring organs, "an elastic cushion on which the gland gently rests" which is maintained by positive intra-abdominal pressure and varies with the movements of the diaphragm during respiration. et l'amarrage du foie fi ses p6dicules vasculaires. La veine cave inf6rieure, dont le r61e essentiel a 6t6 d6termin6 par Faure, suspend le foie par l'interm6diaire des veines sus-h6patiques. La corde ombilico-arantienne, tendue de la veine cave inf~rieure /t la paroi abdominale ant6rieure, supporte le lobe h6patique gauche.Les ligaments du foie et les replis p6riton6aux qui les circonscrivent ne jouent qu'un r61e minime dans la fixation du foie; ils jouent par contre un r61e essentiel dans le cloisonnement des espaces sousdiaphragmetiques. Leur morphologie et leur efficacit6 dans la fixation du foie d6pend du morphotype du sujet, on peut les consid~rer comme des moyens de stabilisation lat6raux.A c6t6 de ces ~16ments anatomiques, relativement facile/t d6crire et fi syst6matiser, un certain nombre d'autres facteurs interviennent dans la fixit6 du foie. On peut aussi consid6rer que le foie prend appui sur les organes qui lui sont sous-jacents, < qu'il est maintenu par la pression qui r6gne dans la vacit6 abdominale et aspir6 par la depression sous-diaphragmatique au cours des mouvements respiratoires. Les moyens de fixit6 du foieR~sum~. De nombreux facteurs statiques ou dynamiques concourrent fi fixer le foie fi la partie sup6r-ieure de l'abdomen. Les facteurs anatomiques fixes sont repr6sent6s essentiellement par la suspension Offprint requests to: JB Flament Historical'It is curious, indeed, to see the liver, massive and heavy, enormous even in comparison with other glands thus positioned, fixed and immovable, rarely displaced, in its normal position at the highest point of the abdo...

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Section: Compartmentalisation Of the Subphrenic Spacesmentioning

confidence: 99%