A rare cause of abdominal pain: Catheter in the middle hepatic vein
. Hemodial Int.
Caption: Figure 1: Hepatic blood flow at the middle hepatic vein
measured by transesophageal echocardiography.
Caption: FIGURE 1: Triple phase CT scan notable for a near water attenuating cyst occupying the central sections of the liver with involvement of the middle hepatic vein
. There are few clustered microcalcifications in the cyst.
Right, left and middle hepatic veins
are veins with imperceptible wall and show triphasic pattern similar to IVC and flow pattern is phasic in response to both cardiac and respiratory cycles.
The liver was transected at a plane just to the right of the middle hepatic vein
using an ultrasonic dissector.
Jenkins described hepatic veins that were "not supposed to be there" in normal livers, patients with three portal veins where surgeons expected to find two, and the unexpected effects of collateral blood vessels that drain the middle hepatic vein
. He marveled at the liver's power to regenerate itself--70%-80% grows back the first month, according to the experience at Lahey in Burlington, Mass.
Dissection is performed so that the middle hepatic vein
always remains on the left lobe.
It was positioned within the middle hepatic vein
at a distance of 3-5 cm from the outlet into the inferior vena cava, keeping the angle of incidence of the doppler ultrasound beam at less than 600.
The issue is how much of the middle hepatic vein
to remove, and whether the surgical plane should go to the left or right.
The purpose of this study was to evaluate the incidence of AHV using MDCT, classify the morphologies, and investigate the factors that may help predict the presence of an AHV by examining the relationship between the presence of an AHV and the diameters of the right hepatic vein (RHV) and middle hepatic vein
Using X-rays as a rough guide, the dissection was started along the Cantlie's line for middle hepatic vein
The liver is divided into right and left lobes by the middle hepatic vein
. Further division into segmental anatomy is achieved by the course of the right and left hepatic veins and porta8.