The hepatorenal recess (subhepatic recess, pouch of Morison or Morison's pouch) is the subhepatic

space Space is a three-dimensional continuum containing positions and directions. In classical physics, physical space is often conceived in three linear dimensions. Modern physicists usually consider it, with time, to be part of a boundless ...

that separates the

liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...

from the right

kidney In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and rig ...

. As a

potential space In anatomy, a potential space is a space between two adjacent structures that are normally pressed together (directly apposed). Many anatomic spaces are potential spaces, which means that they are potential rather than realized (with their realiz ...

, the recess is not normally filled with fluid. However, fluid can collect here in circumstances where the abdomen fills with fluid, such as

hemoperitoneum Hemoperitoneum (also haemoperitoneum, sometimes also hematoperitoneum) is the presence of blood in the peritoneal cavity. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Hemope ...

. This fluid may be seen on

ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...

computed tomography A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

(CT scan).

Clinical importance

Since it is a

, the hepatorenal recess is not normally filled with fluid. However, this space becomes significant in conditions in which fluid collects within the abdomen (most commonly

ascites Ascites (; , meaning "bag" or "sac") is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdo ...

and

). The intraperitoneal fluid, be it blood, ascites, or

dialysate In chemistry, dialysis is the process of separating molecules in Solution (chemistry), solution by the difference in their rates of diffusion through a semipermeable membrane, such as dialysis tubing. Dialysis is a common laboratory technique th ...

, collects in this space and may be visualized, most commonly via

(CT) scanning. As little as 30 or 40 ml of fluid in the abdominal cavity may be visualized in this space. Early visualization of fluid in the hepatorenal recess on

FAST scan Focused assessment with sonography in trauma (commonly abbreviated as FAST) is a rapid bedside ultrasound examination performed by surgeons, emergency physicians, and paramedics as a screening test for blood around the heart (pericardial effusio ...

may be an indication for urgent

laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ...

Etymology

The hepatorenal recess is also called the ''pouch of Morison'', or ''Morison's pouch'', after the

British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories and Crown Dependencies. * British national identity, the characteristics of British people and culture ...

surgeon

James Rutherford Morison James Rutherford Morison (10 October 1853, Hutton Henry County Durham, England – 9 January 1939, Newcastle upon Tyne, England) was a British surgeon. In 1874, he graduated from the University of Edinburgh, and as a young man was an assistant ...

Additional images

File:Morrisons-normal.jpg, A normal ultrasonographic view of Morison's pouch. The bright line is the capsule of the kidney; there is no fluid present and hence no visible space. File:MorisonNoText.png, Ultrasound of liver (left side of the image) and right kidney (right side of the image) and Morison's pouch, not containing fluid File:CT abdomen - liver cirrhosis - 01.JPG, Abdominal CT, showing Morison's pouch as the dark margin surrounding the right kidney (at lower left corner of image) File:Morison003.jpg, Ultrasonographic view of the abdomen demonstrating fluid within Morison's pouch File:Ultrasound Scan ND 0110145312 1506110.png

References

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