Liver segment V !
Liver segment V is the lower front part of the right liver, directly under the gallbladder, so gallbladder disease reaches it first.
Official name: Anterior medial segment of liver
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What it is
Liver segment V: the lower front part of the right lobe, under the gallbladder.
What it does
Because each segment has its own supply, surgeons can remove one or more segments and leave the rest working.
Key facts
- Where
- Right anterior section, inferior part; gallbladder bed, just right of Cantlie line
- Blood supply
- Right anterior portal pedicle (right portal vein, right hepatic artery); drains into middle and right hepatic veins
- Nerve
- Hepatic plexus (celiac sympathetic and vagal fibres) along its portal pedicle, shared with the whole liver
- Function
- Independent surgical unit; bile to right anterior sectoral duct; with IVb it is resected in radical gallbladder surgery
Relations
- Above
- Liver segment VIII, above the plane of the portal bifurcation
- Medial
- Liver segment IV (IVb), across Cantlie line and the middle hepatic vein
- Lateral
- Liver segment VI, beyond the plane of the right hepatic vein
- Below
- Gallbladder in its fossa, hepatic flexure of the colon and the first part of the duodenum
How to find it
At the lower edge of the right liver where the gallbladder fundus meets the right costal margin, near the tip of the ninth costal cartilage in the midclavicular line; it is the liver bed exposed in every cholecystectomy.
On imaging
On CT or MRI it lies below the portal plane, between the middle and right hepatic veins, beside the gallbladder fossa. Focal fatty sparing next to the gallbladder can look like a nodule on ultrasound.
Common problems
- Fatty liver disease, very common with obesity and diabetes.
- Hepatitis (viral, alcohol).
- Cirrhosis: scarring that can lead to liver failure and portal hypertension.
- Liver cancer and metastases.
How it is diagnosed
Blood tests (liver enzymes), ultrasound, elastography, CT or MRI, biopsy.
Treatment
- Treat the cause (weight loss, antiviral medicines, stopping alcohol); surgery to remove segments; liver transplant for failure.
Clinical notes
- Bleeding from the liver bed during cholecystectomy comes from this segment; in some people a branch of the middle hepatic vein runs just under the gallbladder fossa
- Small subvesical ducts (ducts of Luschka) in the gallbladder bed can leak bile after cholecystectomy
Anatomical variants
- A branch of the middle hepatic vein running just under the gallbladder bed in some people, a source of brisk bleeding at cholecystectomy
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Which liver segment lies directly under the gallbladder?
Liver segment V (with IVb), so gallbladder inflammation, perforation and cancer reach it first.
Which hepatic veins bound liver segment V?
The middle hepatic vein on its left (Cantlie line) and the right hepatic vein on its right; the portal plane separates it from segment VIII above.
What can leak bile from the liver bed after cholecystectomy?
Small subvesical ducts (ducts of Luschka) in the gallbladder bed over liver segment V.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- segmentum anterius mediale dextrum hepatis TA2 3076
- Official Spanish (DeCS)
- Segmento V del hígado DeCS D008099
- English (TA2)
- Anterior medial segment of liver
- Also called
- segment V of liver
Related
Sources: Terminologia Anatomica (TA2); DeCS; Diagnostic Imaging of the Liver; Anatomy, Abdomen and Pelvis: Liver; 23.6 Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.
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Representative model, for educational purposes only.
