Digestive system · Abdomen

Liver segment II !

Liver segment II is the upper back part of the left liver, under the left dome of the diaphragm; with segment III it is used in child liver transplants.

Official name: Left posterior lateral segment of liver

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What it is

Liver segment II: the upper part of the left lateral lobe.

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

Left lateral section, superior (posterior) part, left of falciform ligament

Blood supply

Branch of left portal vein and left hepatic artery; drains into left hepatic vein

Nerve

Hepatic plexus (celiac sympathetic and vagal fibres) along its portal pedicle, shared with the whole liver

Function

Independent surgical unit; bile to left hepatic duct; with III it is the left lateral section (used in pediatric living-donor grafts)

Relations

Above

Left dome of the diaphragm, with the heart and the base of the left lung above it

Behind

Abdominal esophagus and the cardia of the stomach; the left triangular ligament anchors its tip to the diaphragm

Below

Liver segment III; on the visceral surface the lesser omentum attaches along the fissure for the ligamentum venosum, next to the caudate lobe

How to find it

High under the left costal margin and the left dome of the diaphragm, behind segment III; in open surgery it comes into view when the left triangular ligament is divided and the left lateral section is folded down.

On imaging

On axial CT or MRI it is the part of the liver left of the left hepatic vein on the upper slices, above the plane of the left portal vein; segment III takes its place on the lower slices.

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

• Freeing it means dividing the left triangular ligament, close to where the left hepatic vein enters the inferior vena cava
• A left-lobe amoebic abscess is less common than a right-lobe one but can rupture into the pericardium or the left pleura
• The left lateral section is held up by a retractor in hiatal hernia repair, fundoplication and gastrectomy; firm or prolonged retraction can bruise or tear it and raise liver enzymes after surgery

Anatomical variants

• A long left lateral section ("beaver tail" liver) can wrap around the spleen and on CT may be mistaken for a splenic collection or haematoma

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)

segmentum posterius laterale sinistrum hepatis TA2 3068

Official Spanish (DeCS)

Segmento II del hígado DeCS D008099

English (TA2)

Left posterior lateral segment of liver

Also called

segment II of liver

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.