Tunnel for ligamentum teres: A rare variation of the liver

Abstract

IntroductionLigamentum teres hepatis, an embryological remnant derived from the obliterated left umbilical vein is lodged on the fissure for the ligamentum teres on the inferior surface of the liver. We report here an anomalous case where the ligament passed through a tunnel instead of a fissure. Case reportThe fissure for ligamentum teres was obliterated by bridging of liver tissue across the quadrate and left lobes. This bridging converted the fissure into a tunnel through which ligamentum teres coursed to its destination. A small fissure extended from the left end of porta hepatis to this tunnel. Lack of separation of lobes, in the early embryonic period might have led to this variation. ConclusionAnomalies like this can often mislead the radiologists or surgeons either in diagnosis or interpretations of liver diseases.

Clinically Oriented Classification of Anatomic Variants of the Umbilical Fissure for Ligamentum Teres in the Human Liver

“…Type IV variants were the most common morphologic variants in our population. These variations have been reported with various names applied to them, such as pons hepatis [5][6]14,16,18,[21][22], absent fissure for ligamentum teres [9,12,17] and ligamentum teres tunnel [10][11]15,19]. We propose the use of standardized nomenclature and classifications, possibly those proposed within this paper.…”

“…There have been reports describing variations of the UF [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], but a robust classification system was not encountered. We proposed a morphologic classification based on the variations encountered.…”

Tunnel for Ligamentum Teres Hepatis- A Case Report

“…Hence the left lobe was continuous with the quadrate lobe. Satheesha et al recently reported a peculiar liver with the total absence of fissure for ligamentum teres and the quadrate lobe (5). A case of liver with the presence of complete tunnel instead of fissure for ligamentum teres on the diaphragmatic surface of the liver with absent quadrate lobe has been reported by Ebby et al (6).…”