Liver 299

1 Fundus of gallbladder

2 Peritoneum (cut edges)

3 Cystic artery

4 Cystic duct

5 Right lobe of liver

6 Inferior vena cava

7 Bare area of liver

8 Notch for ligamentum teres and

falciform ligament

9 Ligamentum teres

10 Falciform ligament of liver

11 Quadrate lobe of liver

12 Common hepatic duct

13 Left lobe of liver

14 Hepatic artery proper

15 Common bile duct Portal triad

16 Portal vein

17 Caudate lobe of liver

18 Ligamentum venosum

19 Ligament of inferior vena cava

20 Appendix fibrosa (left triangular

ligament)

21 Coronary ligament of liver

22 Hepatic veins

23 Porta hepatis Liver (inferior aspect). Dissection of porta hepatis. Gallbladder partly collapsed.

Ventral margin of liver above.

Segmentation of the liver (anterior aspect). Liver segments indicated

by Roman numerals.

Liver (ventral aspect) (transparent drawing illustrating margins of peritoneal folds).

It should be noted that the anatom -

ical left and right lobes of the liver do

not reflect the internal distribution of

the hepatic artery, portal vein, and

biliary ducts. With these structures,

used as criteria, the left lobe includes

both the caudate and qua drate

lobes, and thus the line dividing the

liver into left and right functional

lobes passes through the gallbladder

and inferior vena cava. The three

main hepatic veins drain segments of

the liver that have no visible external

markings.

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Spleen

1 Serratus anterior muscle

2 Left lung

3 Diaphragm

4 Spleen

5 External abdominal oblique muscle

6 Gastrosplenic ligament

7 Splenic artery

8 Pancreas tail

9 Superior margin of spleen

10 Anterior border of spleen

11 Liver

12 Hepatic artery proper

13 Cystic duct

14 Gallbladder

15 Lesser duodenal papilla (probe)

16 Greater duodenal papilla (probe)

17 Duodenum (fenestrated)

18 Cardia

19 Pancreas and pancreatic duct

20 Kidney (with capsula adiposa, capsular fat, adipose tissue)

21 Common bile duct

22 Superior mesenteric artery and vein

23 Ureter

24 Aorta with celiac trunk

25 Suprarenal gland

26 Inferior mesenteric vein

Location of the spleen in situ (left-lateral aspect).

Intercostal spaces and diaphragm have been fenestrated.

Spleen (visceral surface), hilum of spleen with vessels, nerves,

and ligaments.

Upper Abdominal Organs 301

Upper abdominal organs (anterior aspect). Stomach and transverse colon have been removed, the duodenum fenestrated. The liver

has been elevated to show the extrahepatic bile ducts. In this case the accessory pancreatic duct represents the main excretory duct of the

pancreas.

Upper abdominal organs (anterior aspect). The schematic drawing shows the most common situation of the pancreatic ducts.

302 Vessels of the Abdominal Organs: Superior Mesenteric Vessels

1 Greater omentum

2 Middle colic artery

3 Right colic artery

4 Duodenum

5 Ascending colon

6 Ileum

7 Transverse colon

8 Celiac ganglion

9 Duodenojejunal flexure

10 Superior mesenteric vein

11 Superior mesenteric

artery

12 Jejunum

13 Jejunal arteries

14 Ileal arteries

15 Liver

16 Celiac trunk and

abdominal aorta

17 Gallbladder

18 Pancreas

19 Ileocolic artery

20 Stomach

21 Spleen

22 Left colic flexure

23 Appendicular artery

24 Vermiform appendix

Vessels of abdominal organs, dissection of superior mesenteric artery and vein.

Greater omentum and transverse colon are reflected.

Main branches of superior mesenteric artery

(schematic drawing).

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Vessels of the Abdominal Organs: Portal Circulation

Main tributaries of portal vein (blue).

Inferior vena cava = violet; X = sites of portocaval anastomoses.

1 Portal vein

2 Superior mesenteric vein

3 Superior mesenteric artery

4 Right colic vein

5 Ileocolic vein

6 Ileocolic artery

7 Duodenojejunal flexure

8 Middle colic artery

9 Jejunum

10 Jejunal arteries and veins

11 Ileal arteries and veins

12 Inferior vena cava

13 Hepatic veins

14 Liver

15 Para-umbilical veins

(located within the

ligamentum teres)

16 Spleen

17 Left gastric vein with

esophageal branches

18 Splenic vein

19 Inferior mesenteric vein

20 Gastro-omental veins

21 Ileal veins

22 Sigmoid veins

23 Superior rectal vein

Tributaries of portal vein (blue) and branches of superior mesenteric artery (red) (anterior aspect).

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Vessels of the Abdominal Organs: Superior Mesenteric Artery

1 Ligamentum teres

2 Liver

3 Gallbladder and common

bile duct

4 Hepatic artery proper and

portal vein

5 Right gastric artery and

pylorus

6 Gastroduodenal artery

7 Superior mesenteric artery

8 Superior mesenteric vein

9 Ascending colon

10 Duodenum

11 Ileocolic artery

12 Lymph nodes

13 Ileum

14 Cecum

15 Left lobe of liver

16 Caudate lobe of liver

17 Spleen

18 Left gastric artery

19 Splenic artery

20 Pancreas

21 Left colic flexure (cut)

22 Jejunal arteries

23 Ileal arteries

24 Jejunum

25 Middle colic artery

26 Right colic artery

27 Appendicular artery

28 Transverse mesocolon

29 Duodenojejunal flexure

30 Inferior mesenteric artery

31 Left colic artery

32 Sigmoid arteries

33 Superior rectal artery

34 Inferior vena cava

35 Abdominal aorta

36 Descending colon

37 Ileum

38 Sigmoid colon

39 Vermiform appendix

40 Cecum

Superior mesenteric artery in relation to pancreas and duodenum. Stomach and transverse

colon have been removed and the liver elevated. Note the location of the spleen. A yellow probe is

inserted through the omental foramen.

Main branches of superior and inferior mesenteric arteries (schematic drawing). Arrow = Riolan’s anastomosis.

Vessels of the Abdominal Organs: Inferior Mesenteric Artery 305

Vessels of the retroperitoneal organs. Direction of the inferior mesenteric artery and its anastomosis with the middle colic artery

(arrow = Riolan’s anastomosis). Greater omentum and transverse colon have been reflected, the intestine partly removed. The normally

retrocecally located vermiform appendix has been replaced anteriorly. The right common iliac artery is partly obstructed by a blood thrombus.

306 Dissection of the Abdominal Organs

1 Middle lobe of right lung

2 Xiphoid process

3 Costal margin

4 Falciform ligament of liver

5 Quadrate lobe of liver

6 Greater omentum

7 Upper lobe of left lung

8 Heart

9 Diaphragm

10 Left lobe of liver

11 Ligamentum teres

12 Stomach

13 Gastrocolic ligament

14 Transverse colon

15 Taenia coli

16 Appendices epiploicae

17 Cecum

18 Taenia coli

19 Ileum

20 Transverse mesocolon

21 Jejunum

22 Sigmoid colon

23 Position of root of mesentery

24 Vermiform appendix

25 Duodenojejunal flexure

26 Mesentery

Abdominal organs. The anterior thoracic and abdominal walls

have been removed.

Abdominal organs (anterior aspect). The greater omentum, which

is fixed to the transverse colon, has been raised.

Abdominal organs (anterior aspect). The transverse colon

has been reflected.

Dissection of the Abdominal Organs 307

1 Diaphragm

2 Costal margin

3 Transverse colon

4 Ascending colon with haustra

5 Free taenia of cecum

6 Ileum

7 Cecum

8 Falciform ligament of liver

9 Liver

10 Stomach

11 Gastrocolic ligament

12 Jejunum

13 Sigmoid colon

14 Vermiform appendix

15 Terminal ileum

16 Meso-appendix

17 Mesentery

Abdominal organs in situ. The greater omentum has been removed.

Ascending colon, cecum, and vermiform

appendix (detail of the preceding figure).

Variations in the position of the vermiform appendix.

a = retrocecal; b = paracolic; c = retro-ileal; d = pre-ileal;

e = subcecal.

308 Dissection of the Abdominal Organs: Mesenteric Arteries

Abdominal organs. Dissection of inferior mesenteric artery and autonomic plexus. The transverse colon with

mesocolon has been raised and the small intestine reflected.

1 Liver

2 Gallbladder

3 Middle colic artery

4 Jejunal artery

5 Inferior mesenteric artery

6 Sympathetic nerves and ganglia

7 Right common iliac artery

8 Small intestine (ileum)

9 Transverse colon (reflected)

10 Transverse mesocolon

11 Anastomosis between middle

and left colic artery

12 Spleen

13 Abdominal aorta

14 Left colic artery

15 Duodenojejunal flexure

16 Descending colon (free taenia of colon)

17 Inferior mesenteric vein

18 Superior hypogastric plexus

19 Superior rectal artery

20 Sigmoid arteries

21 Peritoneum (cut edge)

22 Sigmoid mesocolon

23 Sigmoid colon

Dissection of the Abdominal Organs: Mesenteric Arteries 309

1 Liver

2 Middle colic artery

3 Horizontal part of

duodenum (extended)

4 Superior mesenteric

artery and vein

5 Right colic artery

6 Ileocolic artery

7 Ascending colon

8 Cecum

9 Greater omentum

(reflected)

10 Transverse colon

11 Transverse

mesocolon

12 Duodenojejunal

flexure

13 Jejunal arteries

14 Jejunum

15 Ileal arteries

16 Mesenteric lymph

nodes and lymph

vessels

17 Ileum

18 Abdominal aorta

19 Inferior vena cava

20 Stomach

21 Spleen

22 Splenic artery

23 Head of pancreas

24 Superior mesenteric

artery

Abdominal organs. Superior mesenteric artery. Mesenteric lymph nodes. Transverse colon reflected.

Frontal section through the abdominal cavity (MRI scan; the intesti nal

tract and vessels are filled with a paramagnetic substance [Gadolinium];

courtesy of Dr. W. Rödl, Erlangen, Germany).

310 Dissection of the Abdominal Organs: Mesentery

1 Lung

2 Diaphragm

3 Falciform ligament of liver

4 Jejunum

5 Ileocecal fold

6 Meso-appendix

7 Vermiform appendix

8 Ileocecal junction

9 Cecum

10 Pericardial sac

11 Xiphoid process

12 Costal margin

13 Liver

14 Stomach

15 Transverse colon

16 Duodenojejunal flexure

17 Inferior duodenal fold

18 Mesentery

19 Position of left kidney

20 Descending colon

21 Position of left common iliac artery

22 Sacral promontory

23 Sigmoid mesocolon

24 Sigmoid colon

25 Rectum

26 Beginning of jejunum

27 Peritoneum of posterior

abdominal wall

28 Transverse mesocolon

29 Superior duodenal fold

30 Superior duodenal recess

31 Retroduodenal recess

32 Free taenia of ascending colon

33 Ileocecal valve

34 Frenulum of ileocecal valve

35 Orifice of vermiform

appendix (probe)

36 Ileocolic artery

37 Vermiform appendix with

appendicular artery

38 Ascending colon

Abdominal cavity. Mesenteries. The small intestine has been reflected laterally to

demonstrate the mesentery.

Duodenojejunal flexure

(enlargement of preceding figure).

Ileocecal valve (ventral aspect). The cecum and terminal part of

the ileum have been opened.

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