Quadrate Lobe Of Liver Research Articles

ANOMALOUS PERITONEAL FOLDS OF LIVER WITH INCOMPLETE FISSURE FOR IGAMENTUM TERES - A CASE REPORT

Liver is the largest organ in the human body occupying right hypochondrium, epigastrium and left hypochondrium. The organ develops in the ventral mesogastrium dividing the latter into a cranial part which forms the falciform ligament and lesser omentum and the caudal part which normally degenerates but may persist occasionally in the form of accessory fissures, ligaments and folds. The present case report describes the occurrence of exceptional and multiple abnormal peritoneal ligaments extending between the liver, diaphragm and abdominal wall. In concurrence, an incomplete fissure for ligamentum teres hepatis is reported which resulted in a communication between the left lobe and quadrate lobe of liver. The knowledge of the normal and the variant anatomy of such peritoneal reflections of liver is of colossal significance for surgeons performing the segmental resection of the liver and radiologists interpreting radiological findings related to liver.

Development of a new technique of embalming and preservation until almost one year at room temperature and dry storage: histological and microbiological analysis

IntroductionIn recent years, a large number of fixation and preservation liquids have been proposed in the search for alternative methods of body preservation. Two processes occur postmortem: putrefaction with bacterial action on body tissues and autolysis with decomposition of the body by endogenous substances. Thus, we intend to present a new formula that allows the body to be preserved with its morphological and mobility characteristics similar to the fresh cadaver, but ensuring its fixation and conservation over time, maintaining at room temperature.Material and MethodWe use a donated 69‐years‐old female body, was embalmed using a new solution based on Baptista et al. (1986) with embalming pump. The formula used was: alcohol 1000 ml; phenol 1000 g; glycerin 1000 ml; sodium nitrate 1000 g; formaldehyde 2000 ml; distilled water 14000 ml. Arterial accesses and complementary injections of formaldehyde were performed in muscles limbs and cranial cavity. The cadaver was maintained at room temperature, ranging from 20.1 to 32.6 °C (68.18–90.68 °F) and the humidity (41–94) in body bag covered with blackout sheet. Samples of tissues (skin and subcutaneous tissue, rectus abdominis muscle, quadrate lobe of liver, transverse colon and brain) were collected after 130, 150, 185, 360 and 512 days of embalming and submitted to histological staining (HE). For the microbiological analysis we used samples after 185 and 360 days and seeded on agar plates (blood, chocolate, and Sabouraud) and placed in liquid medium (TSB) and incubated for 72 hours (35–37 °C).ResultsThis method resulted in soft and flexible cadavers as can be seen at elbow joint (Figs. 1a, 1b) with almost natural colors (Fig. 2). Histological analysis indicated the preservation of tissue and cellular structure in the different samples examined, even after 512 days post‐embalming: skin and subcutaneous tissue (Fig. 3); muscle (Fig. 4); liver (Fig. 5) and brain (Fig 6). The cultures were negative for growth of microorganisms in both analysis (after 185 and 360 days).DiscussionThe cadaver preservation technique presented has low cost and easy execution, being effective in maintaining the morphological characteristics of the anatomical specimen for an extended period of time.ConclusionIt presents as an alternative to anatomical teaching and research centers that have to deal with the toxicity of fixation products and the costs of obtaining and maintaining anatomical specimens.Demonstration of the cadaver elbow joint flexibility after 512 days post embalming;Figure 1Aspect of the coloration of the tissues of the abdominal organs, 360 days post embalming.Figure 2Histological sections after 512 days of fixation of skin and subcutaneous tissue, muscle, liver and brain, respectively. HE. 200x.Figure 3

Comparison of the Gallbladder Fossa in Livers from Cadavers with and without Gallbladders

In humans, the gallbladder normally lies, at least partially, within the gallbladder fossa, a depression located on the visceral surface of the liver, between the right anatomical lobe of the liver and the quadrate liver lobe. During routine cadaveric dissections, we noted that livers from cadavers without gallbladders appeared to have less distinct gallbladder fossae than did livers where gallbladders were present.The purpose of the present study was to test the hypothesis that the volume of the gallbladder fossa is greater in livers when a gallbladder is present than in livers without gallbladders.To test this hypothesis, livers with their associated gallbladder were removed from cadavers and the visceral surface of each sample was observed to determine whether or not a gallbladder was present. After photographing all livers and removing gallbladders, if present, the volume of the irregularly‐shaped gallbladder fossa was determined from a mold of the fossa. To make this mold, an insulating foam sealant (Dow, Midland, MI, USA) was instilled into the area of the fossa. After foam expansion was complete, the material was trimmed flush with the surrounding liver parenchyma. This mold then was removed from the fossa and allowed to air‐dry. The volume of the gallbladder fossa was calculated by dividing the weight of the mold by the density of the foam material. Additionally, the dimensions of each fossa were estimated using an electronic digital caliper (VWR, Radnor, PA, USA) to measure the largest distance for the depth, length, and width of each mold. Statistical analyses were performed using R. Comparison of group means utilized Welch’s t‐test and the Pearson product‐moment correlation coefficient was used for correlation analyses.Livers were obtained from 34 cadavers (19 females, 15 males) with a mean age of 84.1 ± 10.8 yrs (range of 60–105 yrs). There were 8 cadavers without gallbladders (6 females, 2 males, mean age of 83.9 ± 6.6 yrs), and 26 cadavers with gallbladders (13 females, 13 males, mean age of 84.2 ± 11.9 yrs). The mean volume of gallbladder fossae from livers with gallbladders (31.01 ± 17.82 ml) was significantly greater than fossae in livers without gallbladders (8.75 ± 4.72 ml) (p=2.3 e‐06). All three measurements taken of the fossae molds (depth, length, and width) were significantly larger in the “with gallbladder livers” (p<0.05), with the largest percent difference being between the depth of the fossae – mean depth of the fossae mold from livers with a gallbladder was 20.69 ± 6.17 mm versus fossae without gallbladders having a mean depth of 7.60 ± 2.57 mm (p=1.77e‐09). When comparing the volume of fossae to the depth, length, and width of the molds, the correlation was strongest between the volume and the depth of the fossae (r=0.838, p=6.1e‐10).In conclusion, the mean volume of the gallbladder fossa was significantly greater for livers in which a gallbladder was present than in livers lacking gallbladders, with the greatest relative change in the fossae dimensions, after gallbladder removal, occurring with the depth of the fossae. The mechanism behind this change can only be hypothesized, but may be due to proliferation of liver tissue when mechanical pressure from a gallbladder is relieved by organ removal.Support or Funding InformationNone.

Morphology of caudate and quadrate lobe of liver

Morphology of caudate and quadrate lobe of liver

Diagnosis and treatment of delayed postoperative hemorrhage after pancreaticoduodenectomy

Objective To summarize the clinical experience in the diagnosis and treatment of delayed postoperative hemorrhage after pancreaticoduodenectomy.Methods The clinical data of 246 patients who received pancreaticoduodenectomy at the First Affiliated Hospital of Xinjiang Medical University from January 2002 to February 2013 were retrospectively analyzed.Patients with pancreatic head carcinoma and ampullary malignancies received standard pancreaticoduodenectomy or combined organ resection,and patients with benign and duodenal tumor received pylorus-preserving pancreaticoduodenectomy.Pancreatic anastomosis was done using pancreaticogastrostomy or pancreaticojejunostomy.Delayed hemorrhage was defined as bleeding at the operation site after 5 or more postoperative days.Patients were divided into the gastrointestinal hemorrhage group and the abdominal hemorrhage group according to the bleeding site,and the treatment methods included conservative treatment or surgical treatment (including interventional therapy and laparotomy).The Measurement data were expressed as mean ± standard deviation,and the enumeration data were compared using the Fisher exact probability.Results There were 224 patients received pancreaticoduodenectomy,10 received pylorus-preserving pancreaticoduodenectomy,9 received pancreatieoduodenectomy + portal vein resection or replacement,1 received pancreaticoduodenectomy + superior mesenteric vein replacement,1 received pancreaticoduodenectomy + resection of quadrate lobe of liver and 1 received pancreaticoduodenectomy + resection of left semihepatectomy.There were 127 patients received improved end-to-side pancreaticojejunostomy,53 received pancreaticogastrostomy,39 received end-to-end pancreaticojejunostomy and 27 received mucosa-to-mucosa pancreaticojejunostomy.Fifteen patients died perioperatively,with the mortality rate of 6.10％ (15/246).Twenty-nine patients were complicated with delayed hemorrhage with the rate of 11.79％ (29/246),including 14 with gastrointestinal hemorrhage and 15 with abdominal hemorrhage.There were 9 patients with mild hemorrhage (5 with gastrointestinal hemorrhage and 4 with abdominal hemorrhage) and 20 with severe hemorrhage (9 with gastrointestinal hemorrhage and 11 with abdominal hemorrhage).Seventeen patients had sentinel bleeding,including 5 with abdominal hemorrhage and 12 with gastrointestinal hemorrhage.Twenty-nine patients received conservative treatment,and the success rates of conservative treatment were 8/14 in the gastrointestinal hemorrhage group,which was significantly higher than 2/15 of the abdominal hemorrhage group (P ＜ 0.05).Patients who failed in conservative treatment received surgical treatment.Of the 20 patients with severe hemorrhage,19 were cured by surgical treatment and I was cured by conservative treatment.Nine patients with mild hemorrhage received conservative treatment,8 were cured and 1 died of pulmonary infection.Of the 29 patients with delayed postoperative hemorrhage,10 died with the mortality rate of 34.5％ (10/29).The morality rate of the gastrointestinal hemorrhage group was 2/14,which was lower than 8/15 of the abdominal hemorrhage group,with no significant difference between the 2 groups (P ＞ 0.05).Conclusions Most of the delayed postoperative hemorrhage after pancreaticoduodenectomy severe and combined with sentinel bleeding.Gastrointestinal hemorrhage can be cured through conservative treatment,but abdominal hemorrhage need surgical treatment. Key words: Pancreaticoduodenectomy ; Postoperative hemorrhage ; Diagnosis ; Treatment

Acute Hemobilia and Hemocholecyst in 2 Dogs with Gallbladder Carcinoid

Acute Hemobilia and Hemocholecyst in 2 Dogs with Gallbladder Carcinoid

A possible role of a blood vessel in formation of the fat area in the quadrate lobe of porcine liver.

Approximately a half of swine examined had a fat storing area (F-area) in the quadrate lobe of the liver. This area was stained strongly by Sudan Black B (fat staining) and PAS (carbohydrate staining). The area was light brown to greyish yellow in appearance due to the deposition of lipid droplets. In cross section the F-area was wedge-shaped, and had a specific venous supply which directly connected it to the right gastric vein. The larger the connecting vein the wider the F-area, indicating that the connecting vein, not reported so far, is a key factor in the formation of the F-area. This would be a good model for the formation of partial fatty liver.