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ECR 2019 / C-1885
Porta hepatis: Pandora’s Box, what the radiologist needs to know.
Congress: ECR 2019
Poster No.: C-1885
Type: Educational Exhibit
Keywords: Education and training, Education, Diagnostic procedure, Ultrasound, MR, CT, Abdomen
Authors: M. AbouRayan1, M. T. El-Diasty2, F. Serag El-Din1; 1Alexandria/EG, 2Jeddah/SA
DOI:10.26044/ecr2019/C-1885

Background

 

 

Porta hepatis, a Latin word for liver gate, contains the main portal vein, common hepatic artery, common hepatic duct, nerves, lymphatics and connective tissues.

 

Pathologies arising from these structures can be classified as vascular versus non-vascular or benign versus malignant entities. Additionally, lesions from adjacent structures such as duodenum and pancreatic head can extend into the porta hepatis.

 

Advances in imaging modalities enabled accurate detection with excellent spatial resolution, thus improving patient management and outcome.

 

Anatomy of the Porta Hepatis

 

The porta or transverse fissure (porta hepatis) is a short but deep fissure, about 5 cm long, extending transversely across the under surface of the left portion of the right liver lobe, nearer to its posterior surface than its anterior border. It joins nearly at right angles with the left sagittal fossa, and separates the quadrate lobe in front from the caudate lobe and process behind. [1]

 

The portal vein, proper hepatic artery, and nerves ascend the porta hepatis, whereas the common bile duct and lymphatics descend the porta hepatis.

 

All of these structures are enveloped in the free edge of the lesser omentum or hepatoduodenal ligament, loose areolar tissue, and the fibrous capsule of Glisson. The hepatoduodenal ligament inserts distally between the first and second parts of the duodenum. [2]

 

 

Fig. 1: Axial CT image and corresponding colored illustration at the level of porta hepatis showing CBD (orange arrow), CHA (blue arrow) & PV (black arrow)
References: Moeller TB, Reif E. Pocket Atlas of Sectional Anatomy. 3rd ed. Thieme; 2007.

 

 

Fig. 2: Porta Hepatis; sagittal cross section diagram and corresponding MRI.
References: Moeller TB, Reif E. Pocket Atlas of Sectional Anatomy. 3rd ed. Thieme; 2007.

 

 

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