Liver Ligaments

Mnemonic

All are peritoneal folds, and most carry an obliterated fetal vessel:

• Falciform ligament, attaching the liver to the anterior abdominal wall, carrying the ligamentum teres (the obliterated left umbilical vein) in its free edge
• Ligamentum venosum, the obliterated ductus venosus, in a fissure between the caudate and left lobes
• Coronary and triangular ligaments, reflections that bound the bare area
• Lesser omentum, from the lesser curve to the liver, whose free edge contains the portal triad

“Teres from the vein, venosum from the duct”, both remnants of the fetal circulation that bypassed the liver.

The free edge of the lesser omentum forms the anterior boundary of the epiploic foramen and is what is compressed in the Pringle manoeuvre to control hepatic bleeding.

Expansion

• Falciform ligament - a sickle-shaped fold from the anterior abdominal wall to the liver, dividing the anatomical right and left lobes. Its free edge carries the ligamentum teres
• Ligamentum teres - the obliterated left umbilical vein; recanalises in portal hypertension to feed the paraumbilical veins
• Coronary ligament - the reflection around the bare area; its edges form the left and right triangular ligaments
• Ligamentum venosum - the obliterated ductus venosus, in a fissure between the caudate and left lobes

The bare area is the region on the posterior surface with no peritoneal covering, directly against the diaphragm. It is the site of a portosystemic anastomosis, and it allows infection to spread directly between liver and thorax.

Note that the falciform ligament marks the anatomical division of the lobes, which does not correspond to the functional division along Cantlie’s line.