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Hepatic surface grooves in Trinidad and Tobago

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Abstract

Purpose

Hepatic surface grooves (HSGs) are prominent depressions on the antero-superior surface of the liver. We sought to document the prevalence of HSGs in an Eastern Caribbean population.

Methods

We observed all consecutive autopsies performed at a facility in Trinidad and Tobago and recorded the presence, number, location, width, length and depth of any HSG identified. Each liver was then sectioned to document intra-parenchymal abnormalities.

Results

Sixty Autopsies were observed. There were HSGs in 9 (15%) cadavers (5 females and 4 males), at an average age of 66 years (range 48–83, Median 64, SD ± 10.4). The HSGs were located on the diaphragmatic surface of the right hemi-liver in 8 (89%) cadavers, left medial section in 4 (44%), left lateral section in 3 (33%) and coursing along Cantlie’s plane in 3 (33%) cadavers. Eight (89%) cadavers with HSGs had other associated anomalies: accessory inferior grooves (5), parenchymal nutmeg changes (5), abnormal caudate morphology (4), hyperplastic left hemi-liver (3), lingular process (2), bi-lobar gallbladder (1) and/or abnormal ligamentous attachments (1).

Conclusions

Approximately 15% of unselected Afro-Caribbean persons in this Eastern Caribbean population have HSGs. Every attempt should be made to identify HSGs on pre-operative imaging because they can alert the hepatobiliary surgeon to: (1) associated anatomic anomalies in 89% of cases, (2) associated hepatic congestion in 56% of persons, (3) increased risk of bleeding during liver resections and (4) increased technical complexity of liver resections. The association between HSGs, cardiovascular complications, hepatic congestion and nutmeg liver prompted us to propose a new aetiologic mechanism for HSG formation, involving localized hyperplasia at growth zones due to upregulation of beta-catenin levels.

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All data will be made available to the editorial board upon request.

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Acknowledgements

The authors confirm that there are no financial or other limitations that serve as a conflict of interest in this research. There were no financial support or research grants made available to support this research. The authors wish to thank Dr. Valery Alexandrov for facilitating anatomic dissections for this study.

Funding

No funding or research grants were made available to facilitate this research.

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Authors and Affiliations

  1. Port of Spain General Hospital, Port of Spain, Trinidad and Tobago

    Shamir O. Cawich, Reyad R. A. Ali, Janet Charles, Sherrise Sandy & Vijay Naraynsingh

  2. University of the West Indies, Mona Campus, Kingston 7, Jamaica

    Michael T. Gardner

  3. Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK

    Neil W. Pearce

Authors
  1. Shamir O. Cawich
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  2. Reyad R. A. Ali
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  3. Michael T. Gardner
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  4. Janet Charles
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  5. Sherrise Sandy
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  6. Neil W. Pearce
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  7. Vijay Naraynsingh
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Contributions

SOC: protocol development, data management, data analysis, manuscript writing.RAA, JC, SS: data collection, data analysis, manuscript editing. MTG, NWP, VN: data analysis, manuscript editing, protocol development.

Corresponding author

Correspondence to Shamir O. Cawich.

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This research was approved by the local institutional board.

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Cawich, S.O., Ali, R.R.A., Gardner, M.T. et al. Hepatic surface grooves in Trinidad and Tobago. Surg Radiol Anat 42, 1435–1440 (2020). https://doi.org/10.1007/s00276-020-02540-5

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  • DOI: https://doi.org/10.1007/s00276-020-02540-5

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