Peritoneal Ligaments of Liver

The liver is covered entirely by the visceral peritoneum, apart from a patch called bare area. The peritoneum serves to reduce friction against other organs. At places, it is folded back upon itself to form the so-called peritoneal ligaments. It should be kept in mind that these ligaments have mostly no functional importance and are related to the anatomic ligaments of joints neither by structure or function.

Falciform ligament:

This two layered fold of peritoneum ascends from the umbilicus to the liver. It has a sickle shaped free margin containing the ligamentum teres, which represents the remains of umbilical vein.

The falciform ligament passes to the anterior and superior surfaces of the liver and eventually splits into two layers: right and left. The right layer forms the upper layer of the coronary ligament, while the left layer forms the upper layer of the left triangular ligament. The description could be made easy by considering the fact that the tip of the coronary ligament is known as the right triangular ligament. Between the peritoneal layers forming the coronary ligament lies the so called bare area.

Ligamentum teres:

As described above, this ligament represents the remains of the umbilical vein of fetus. It passes into a fissure on the visceral surface of liver and joins the left branch of portal vein in the porta hepatis.

Ligamentum venosum:

It represents the remains of the ductus venosus of fetus and is attached to the left branch of the portal vein. It ascends in a fissure on the visceral surface of liver to be attached above to the inferior vena cava.

To make the description more understandable, the knowledge of functions of umbilical vein and ductus venosus is important. In brief, the umbilical vein (represented by ligamentum teres) brings oxygenated blood to the liver from placenta in the fetus. The greater portion of this blood bypasses the liver through the ductus venosus (represented by the ligamentum venosum), which joins the inferior vena cava.

Lesser omentum:

In addition to the above peritoneal ligaments, the lesser omentum is also attached to the liver. It arises from the edges of the porta hepatis and the fissure for ligamentum venosum. Afterwards, it passes down to the lesser curvature of the stomach.