The perihepatic spaces: computed tomographic and ultrasound imaging.

Abstract

The appearance of perihepatic fluid collections on sectional imaging is discussed. The coronary ligamentous attachments of the right lobe of the liver to the diaphragm delineate a bare area that separates the right subphrenic and posterior subhepatic spaces. These attachments explain the configuration of right perihepatic fluid collections on sectional images and allow differentiation of subphrenic, posterior subhepatic, and pleural fluid with ultrasound and computed tomography. More medially, the caudate lobe of the liver invaginates the superior recess of the lesser sac, so that fluid collections within this recess may mimic intrahepatic masses on sectional images. This is illustrated with anatomic sections, computed tomographic scans, and ultrasound images.

Unusual portosystemic collateral penetrating the liver parenchyma

“…The right superior and inferior coronary ligaments are peritoneal reflections that attach the posterior superomedial surface of the right lobe of the liver to the diaphragm. Between the superior and inferior coronary ligaments lies the bare area of the liver, which is devoid of peritoneum [9]. Therefore, it is strongly suggested in our case that the dilated peripheral branch of the intrahepatic portal vein passed through the bare area and communicated with the inferior vena cava via the right inferior phrenic or supraadrenal vein.…”

Role of Imaging in Peritoneal Surface Malignancies

“…The right supramesocolic space can be subdivided into 3 spaces, which communicate freely with the right paracolic space [9] (a). Right subphrenic space -between the diaphragm and the right lobe of the liver (b).…”

“…[9] The larger left inframesocolic space freely communicates with the pelvis, except at the sigmoid mesocolon. The right infracolic space is bound inferiorly by the caecum.…”

“…The right infracolic space is bound inferiorly by the caecum. [9] Paracolic gutters represent peritoneal recesses lateral to the ascending and descending colon. Although both paracolic spaces freely communicate with the pelvis, it is only the larger right paracolic space that communicates with the right supramesocolic space.…”

“…Although both paracolic spaces freely communicate with the pelvis, it is only the larger right paracolic space that communicates with the right supramesocolic space. [9].…”