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    Liver

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    Widyan Putra Anantawikrama
    This document discusses the anatomy and clinical aspects of the liver. It describes the liver lobes and segments, blood supply from the hepatic portal vein and hepatic arteries, and drainage into the hepatic veins. Common clinical conditions are summarized such as hepatitis, liver enlargement (hepatomegaly), cirrhosis, and portal hypertension. Surgical procedures for the liver including lobectomy, segmentectomy, and portosystemic shunts are also mentioned.

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    Liver

    Uploaded by

    Widyan Putra Anantawikrama
    83 views18 pages
    This document discusses the anatomy and clinical aspects of the liver. It describes the liver lobes and segments, blood supply from the hepatic portal vein and hepatic arteries, and drainage into the hepatic veins. Common clinical conditions are summarized such as hepatitis, liver enlargement (hepatomegaly), cirrhosis, and portal hypertension. Surgical procedures for the liver including lobectomy, segmentectomy, and portosystemic shunts are also mentioned.

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    liver anatomy

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    This document discusses the anatomy and clinical aspects of the liver. It describes the liver lobes and segments, blood supply from the hepatic portal vein and hepatic arteries, and drainage into the hepatic veins. Common clinical conditions are summarized such as hepatitis, liver enlargement (hepatomegaly), cirrhosis, and portal hypertension. Surgical procedures for the liver including lobectomy, segmentectomy, and portosystemic shunts are also mentioned.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    83 views18 pages

    Liver

    Uploaded by

    Widyan Putra Anantawikrama
    This document discusses the anatomy and clinical aspects of the liver. It describes the liver lobes and segments, blood supply from the hepatic portal vein and hepatic arteries, and drainage into the hepatic veins. Common clinical conditions are summarized such as hepatitis, liver enlargement (hepatomegaly), cirrhosis, and portal hypertension. Surgical procedures for the liver including lobectomy, segmentectomy, and portosystemic shunts are also mentioned.

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    You are on page 1of 18

    Liver position

    Hepar Structure
    Liver Lobe and Couinauds Liver
    Segment

    Cantlie line Cantlie line


    Innervasi Hepar
    N. Splanchnici Major (segmen T6-T9 medulla spinalis)
    Plexus
    Truncus Vagal Anterior et Posterior Coeliacus

    Plexus
    Hepaticus
    Liver Lymph Node
    Embryology of
    Liver and
    Gallbladder
    Arterial blood supply of hepar
    Portal and Hepatic bile duct
    Hepatic Vein
    Drainage
    v. Mesenterica inferior v. lienalis

    v. Lienalis + v. mesenterica superior


    v. porta hepatica

    v. Gastrica dextra et sinistra vena


    porta hepatica

    v. Porta hepatica right and left


    divisions vv. Hepatica v.
    hepatica dextra, media, sinistra
    VCI
    Anastomosis
    Portocava
    Cardia gaster:
    v. gastrica sinistra (P)
    v. esophagealis (C)

    Periumbilical:
    v. paraumbilicalis (P)
    v. epigastrica superficial (C)

    Retroperitoneal:
    [veins of secondary retroperitoneal organ vs
    veins of posterior abdominal wall]
    v. colica sinistra (P)
    v. lumbalis ascendens (C)

    Rectum
    v. rectalis superior (P)
    v. rectalis media et inferior (C)
    Peritoneal Reflection
    Bare area

    Epiploic
    foramen
    Hepatitis
    Kondisi dimana terjadi inflamasi pada
    hepar. Biasanya disebabkan oleh infeksi
    virus HAV. HBV, HCV, dkk.

    Gejala umum: Fatigue. Nausea/vomiting,


    Abdominal pain or discomfort di
    epigastrik/RUQ, low grade fever,
    jaundice, dsb.

    Nyeri pada hepatitis dibawa oleh plexus


    hepaticus melalui sympathetic visceral
    afferent fiber secara retrograde yg
    berjalan bersama trias porta menuju ke Hepar sebagian Innervasi oleh nervus C3-C5
    plexus coeliacus lalu ke medulla spinalis ada reffered pain ke n. phrenicus
    segmen T6-T9.

    BOAS SIGN
    Hepatomegaly
    Yaitu terjadinya pembesaran
    (enlargement) dari hepar, basanya
    diakibatkan hepatitis, heart failure,
    dengue fever, peningkatan CVP,
    tumor, dsb.

    Hepatomegaly peregangan pada


    capsula glisson abdominal RUQ
    pain.
    Hepatomegaly terpalpasi di regio
    lumbal dextra.
    Metastatic tumor : 2 rute
    Hematogen, via sistem vena
    porta
    Limfogen, biasanya dari right
    breast (venous drainage sebagian
    ke diafragma bare area of liver)
    Hepatic Cirrhosis
    Chronic Inflammation or liver
    damage (alcohol etc) hepatocytes
    damage scarring and nodule
    Sirosis hepatis portal system
    constriction portal
    hypertension

    Nodulasi pada hepar hobnail


    appearance

    Portal hypertension many


    manifestations
    Portal
    Hypertension
    Biasanya diakibatkan sirosis hepatis
    stasis blood flow to hepar
    vasodilatasi pre hepaticum ascites,
    manifest di anastomosis portocava:

    Cardia gaster Varices esophagus


    ruptur blood stained vomiting

    Periumbilical superficial abdominal


    wall vein dilatation caput medusae

    Rectal stasis of blood flow


    hemorrhoid
    Portosystemic
    shunt

    Salah satu treatment hipertensi


    portal adalah dengan membuat
    shunt untuk mengurangi stasis
    darah prehepatik dialihkan
    langsung ke sistem caval

    Ada 3 jenis: Side to side, end to side,


    central splenorenal portosystemic
    shunt
    Subphrenic and
    hepatorenal
    Abscess

    Inflamasi organ viscera


    ruptur/perforasi eksudat purulen
    di cavitas peritoneum peritonitis
    mengalir ke recessus hepatorenal
    mengalir ke recessus
    subphrenicus

    Drainase biasanya dengan pungsi


    pada SIC 12 sehingga tidak perlu
    menembus cavitas pleura
    Hepatic Lobectomy and
    Segmentectomy
    Right hepatic lobectomy Hepatic segmentectomy

    Jika prosedur mengangkat bagian hepar yang sudah nekrosis (cirrhosis)


    Resectional Debridement

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