Expansion
Portal triad in front, inferior vena cava behind, caudate lobe above, duodenum below
Expansion
- Anteriorly - the hepatoduodenal ligament containing the portal triad: bile duct, hepatic artery and portal vein
- Posteriorly - the inferior vena cava
- Superiorly - the caudate lobe of the liver
- Inferiorly - the first part of the duodenum
The classic mnemonic for the front is DAVE: Duct, Artery, Vein, Epiploic foramen behind.
The Pringle manoeuvre exploits this arrangement directly. Passing a finger through the foramen and pinching the hepatoduodenal ligament between finger and thumb occludes the hepatic artery and portal vein, controlling inflow bleeding from a liver injury. Bleeding that continues despite this must be coming from the hepatic veins or the inferior vena cava behind.