Midline-triangular liver presenting with extrahepatic porto-vena cava communication

Abstract

The current observation has documented a 50 years old male cadaver with anomalous triangular liver that was situated in the midline of the abdomen, occupying the epigastrium, umbilical and the suprapubic regions and pushing the small intestines into the pelvic cavity. The triangular liver contained two separate right and left portions that were attached by the peritoneal folds to the anterior abdominal wall, xiphoid process and lower costal cartilages. The left liver portion received a direct arterial supply from the aorta. The portal vein gave rise into two extrahepatic tributaries that opened directly into the inferior vena cava. Other anomalies that were observed in the abdomen included the oval-shaped stomach located in the left abdomen and extending into the left lumbar region. The transverse colon was situated in the suprapubic region and small intestines occupied the suprapubic region and the pelvic cavity. The right testicular vein drained into the right renal vein. The current observations report for the first time midline triangular liver occurring with extrahepatic porto-vena cava communication. The origin of the anomalies of hepatic morphology occurring in the course of organogenesis remains to be determined. Continued documentation of liver anomalies remains to be important in medical practice and in the understanding of liver ontogeny.

Keywords

liver - porta hepatis - inferior vena cava - ventral mesogastrium - congenital anomalies