Abstract
Aim
The purpose of this study was to clarify the anatomical detail of the superior group of vessels in the falciform ligament in terms of the relationship with the internal thoracic vessels, inferior phrenic vessels, and the intrahepatic portal vein.
Materials and methods
(1) Anatomical study: we dissected eight adult human cadavers (seven normal and one cirrhotic liver) to determine the relationship between the superior group of vessels in the falciform ligament, the internal thoracic vessels, and the inferior phrenic vessels. (2) Clinical study: we determined the origin and destination of the superior group of veins demonstrated in 8 of 4,006 patients with chronic liver disease who underwent the contrast enhanced CT scans.
Results
(1) Anatomical study: the superior group of vessels anastomosed the right (n = 4), left (n = 2), and both (n = 2) internal thoracic vessels. They also anastomosed the left (n = 4), right (n = 1), and both (n = 2) inferior phrenic vessels. (2) Clinical study: the origin of the veins was identified as the left medial branch (n = 4), left lateral branch (n = 1), both the lateral and medial branches (n = 1), and the vein from the umbilical portion (n = 2) of the left portal vein. The drainage vein was identified as the left (n = 3), right (n = 2), and the both (n = 1) internal thoracic veins.
Conclusion
We demonstrated the anastomoses between the superior group of vessels of the falciform ligament, the internal thoracic vessels, the inferior phrenic vessels, and the intrahepatic portal vein. These pre-existing anastomoses would develop as porto-systemic shunt in patients with portal hypertension.
Similar content being viewed by others
References
Cho KC, Patel YD, Wachsberg RH, Seeff J (1995) Varices in portal hypertension: evaluation with CT. Radiographics 15:609–622
Henriquez-Pino JA, Gomes WJ, Prates JC, Buffolo E (1997) Surgical anatomy of the internal thoracic artery. Ann Thorac Surg 64:1041–1045
Ibukuro K, Tsukiyama T, Mori K, Inoue Y (2000) Transhepatic portosystemic shunts: CT appearance and anatomic correlation. AJR 175:153–157
Kim HC, Chung JW, Choi SH, Jae HJ, Lee W, Park JH (2007) Internal mammary arteries supplying hepatocellular carcinoma: vascular anatomy at digital subtraction angiography. Radiology 242:925–932
Lachman N, Satyapal KS (1999) Origin and incidence of xiphoid branch of the internal thoracic artery. Surg Radiol Anat 21:351–354
Lafortune M, Constantin A, Breton G, Legare AG, Lavoie P (1985) The recanalized umbilical vein in portal hypertension: a myth. AJR 144:549–553
Li XP, Xu DC, Tan HY, Li CL (2004) Anatomical study on the morphology and blood supply of the falciform ligament and its clinical significance. Surg Radiol Anat 26:106–109
Lin G, Lunderquest A, Hagerstrand I (1984) Umbilical and paraumbilical veins in ligamentum teres. Acta Radiol Diagn 24:1–5
Martin BF, Tudor RG (1980) The umbilical and paraumbilical veins of man. J Anat 130:305–322
Morin C, Lafortune M, Pomier G, Robin M, Breton G (1992) Patent paraumbilical vein: anatomic and hemodynamic variants and their clinical importance. Radiology 185:253–256
Nordenson NT, Petren T, Wising PJ (1930) Uber das konstante Vorkommen einer fettansammlung um die Insertion des Lig. Falciforme hepatis in die vordere Bauchwand. Z Anat Entwicklungsgesch 93: 223–242
Sappey C (1883) Mémoire sur les veines portes accessories. J Anat Physiol 19:517–524
Suh SH, Won JY, Lee DY, Lee JT, Lee KW (2005) Chemoembolization of the left inferior phrenic artery in patients with hepatocellular carcinoma: radiographic findings and clinical outcome. J Vasc Interv Radiol 16:1741–1745
Tetalman MC, Kusumi R, Gaughran G, Baba N (1978) Radiolnuclide liver spots: indicator of liver disease or a blood flow phenomenon. Am J Roentgenol 130:291–296
Weissmann HS, Sugarman LA, Rosen NL, Freeman LM (1980) Unusual location of a liver “hot spot” in a patient with superior vena cava obstruction. Clin Nucl Med 5:489–491
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ibukuro, K., Tanaka, R., Fukuda, H. et al. The superior group of vessels in the falciform ligament: anatomical and radiological correlation. Surg Radiol Anat 30, 311–315 (2008). https://doi.org/10.1007/s00276-008-0325-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-008-0325-6