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. 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 ...
or
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
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 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
hemoperitoneum). The intraperitoneal fluid, be it blood, ascites, or
dialysate, collects in this space and may be visualized, most commonly via
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 ...
or
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) 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 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.
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
{{Authority control
Abdomen