520 ABDOMEN 



The portion of the right lobe which lies in front of the porta 

 and between the fossa for the gall-bladder on the right and 

 the fossa for the umbilical vein on the left is the quadrate 

 lobe, which frequently bears impressions made by the pylorus 

 and the first part of the duodenum. Behind the porta and 

 between the lower ends of the fossa for the ductus venosus 

 and the fossa for the inferior vena cava is the lower end of 

 the caudate lobe, which is usually divided, by a shallow 

 sulcus, into a nodular left or papillary process, which pro- 

 jects downwards into the cavity of the omental bursa, 

 and a right, band -like or caudate process which connects 

 the lower end of the caudate lobe with the main part of 

 the lower surface of the right lobe. The remainder of 

 the lower surface of the right lobe is marked by three 

 shallow impressions; (i) at the right extremity of the porta 

 hepatis is an antero-posterior sulcus, the impressio duodenalis, 

 for the second part of the duodenum ; (2) to the right of the 

 fossa for the gall-bladder is the impressio colica for the hepatic 

 flexure of the colon ; (3) behind the impressio colica is the 

 impressio renalis for the upper part of the anterior surface of 

 the right kidney. Occasionally a fourth impression exists 

 behind the impressio duodenalis ; this is the impressio supra- 

 renalis, which is always present on the posterior surface and 

 which may extend on to the inferior surface. 



The lower surface of the left lobe is marked by an 

 elevation, the tuber omentale, and a depression, the impressio 

 gastrica. The tuber omentale lies immediately opposite the 

 left extremity of the porta hepatis and, when the liver is in 

 position, it rests against the lesser omentum immediately above 

 the small curvature of the stomach. The gastric impression 

 occupies the remainder of the lower surface of the left lobe 

 lying in front and to the left of the tuber omentale. 



The Posterior Surface of the Liver (Figs. 200 and 201). 

 This is moulded upon the front of the vertebral column, from 

 which it is separated by the diaphragm and the lower part of 

 the descending thoracic aorta. It presents, therefore, a deep 

 hollow corresponding to the bodies of the vertebras and the 

 structures in front of them. Immediately to the left of the 

 fossa of the ductus venosus there is a smooth notch or 

 groove impressio cesophagea which leads downwards into the 

 gastric impression on the under surface of the left lobe. This 

 groove lodges the oesophagus. Beyond the oesophageal groove 



