Title: A Spectrum of Morphological Variations in the human liver lobes and its Clinical importance; a Cadaveric Study
Authors: Dr S.Saritha, Dr Usha rani, Dr Gayatri, Dr Peter, Mrs Asra Anjum, Mrs Himabindu.N
DOI: http://dx.doi.org/10.18535/jmscr/v4i1.06
Most common morphological variations of liver are irregularities in the form, shape, and presence of number of accessory lobes, accessory fissures or abnormal ligaments. Knowledge and awareness of these anomalies is useful to the clinician to rule out diseases, surgeons during segmental resection of liver and radiologist when interpreting liver radiologic findings. The exact origin of accessory lobes of liver in man is unknown and may stimulate tumours. Accessory fissure may mimic internal trauma at the post-mortem study. Rare abnormalities are atrophy or complete absence of one of the lobes. The developmental anomalies of liver may cause confusion to clinician during procedures like biopsy, transplantation & other important surgical or radiological procedures. Aim of the present study comprises a systematic analysis of the anatomical variations exhibited by 50 formalinised and glycerinated adult human livers collected from department of Anatomy, KAMSRC(Hyderabad) &KIMS (Narketpally). Results & Conclusion: We found accessory liver lobes in 8 cadavers (16%), accessory fissures in 15 cases (30%), abnormal connection between left lobe and quadrate lobe in 2 cases (4%) and other morphological variations were also present. Detailed knowledge of anatomical variations in the human liver could be valuable in improving diagnostic procedures .in conditions associated with some liver diseases. Hence we undertook this comprehensive study to identify important accessory lobes and fissures. Key words: quadrate lobe, caudate lobe, liver, accessory lobes & accessory fissures.. 1. Standring.S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice 40th ed. New York: Churchill Livingstone 2008;3441-46. 2. GUYTON, CA. and HALL, JH. Tratado de FisiologiaMédica. Rio de Janeiro: Elsevier, 2006. 3. AKTAN, ZA., SAVAS, R., PINAR, Y. and ARSLAN, O. Lobe and segment anomalies of the liver. Journal of Anatomical Society ofIndia., 2001, vol. 50, n. 1, p. 15 4. O. C. Bradley, “A contribution to the morphology and development of the mammalian liver,” Journal of Anatomy and Physiology, vol. 43, pp. 1–42, 1908. View at Google Scholar 5. Daver GB, Bakhshi GD, Patil A, Ellur S, Jain M, DaverNG. Bifid liver in a patient with diaphragmatic hernia. Indian J Gastroenterol. 2005;24(1):27-8 6. Champetier J, Yver R, Létoublon C, Vigneau B. Ageneral review of anomalies of hepatic morphologyand their clinical implications. AnatomiaClinica,1985;7(4):285-299). 7. PARKE, WW., SETTLES, HE., BUNGER, PC. and VAN DEMARK, RE. Malformations of the liver: some prenatal and postnatal developmental aspects. Clinical Anatomy, 1996, vol. 9,n. 5, p. 309-316. 8. T. S. Cullen, “Accessory lobes of the liver,” Archives of Surgery, vol. 11, pp. 718–764, 1925. View at Google Scholar 9. Y. H. Auh, W. A. Rubenstein, and K. Zirinsky, “Accessory fissures of the liver: CT and sonographic appearance,” American Journal of Roentgenology, vol. 143, no. 3, pp. 565–572, 1984. View at Google Scholar View at Scopus 10. Hussein M, Usman N, Gupta R, Sharma Kr.Morphological variations of liver lobes and itsclinical significance in north Indian populationG.J M.M.S. 2013; 1(1):1-5 11. Sato S, Watanabe M, Nagasawa S, Niigaki M, Sakai S, Akagi S (1998) Laproscopic observations of congenital anomalies of the liver. GastrointestEndosc.; 47: 136-140 12. Hansborough ET, Lipin RJ.Intrathoracic accessory lobe of the liver. Ann Surg.1975; 145:564-67 13. Joshi SD, Joshi SS, Athavale SA. Some interesting observations on the surface features of the liver and their clinical implications. Singapore Med J 2009;50:715–719. 14. Pujari BD, Deodhare SG. Symptomatic accessory lobe of liver with a review of the literature. Postgrad Med J. 1976; 52:234-36 15. Anjamrooz and Azari Coexistence of multiple anomalies in the hepatobiliary system Anat Cell Biol. 2012 Mar;45(1):62-5. doi: 10.5115/acb.2012. 45.1.62. Epub 2012 Mar 31 16. Riedel BM. Uber den zungenformigen Fortsatzdesrechten Leberlappens und seine pathognostische Bedeutung fur die Erkrankungder Gallenblasenebst Bemer-kungenuber Gallenstein operationen. Berlin Klin Wschr. 1888;25:577 17. NETTER, FH. Atlas de Anatomia Humana. Porto Alegre: Artmed, 2000.Abstract
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