Accessory sulci of the liver An anatomical study with clinical implications

Objective: To study the presence of accessory sulcus (AS) in the embalmed cadaveric livers, and compare it with the normal liver. Methods: The present study was conducted on 40 embalmed cadaveric livers in the Department of Anatomy, National University of Malaysia, Kuala Lumpur, Malaysia, from September to October 2007, in order to observe the presence and pattern of anomalous AS. Results: Out of the 40 liver specimens studied, we observed the presence of AS in only 2 specimens (5%). The AS was located in the inferior and posterior surfaces of the right lobes in 2 specimens. Conclusion: The AS of the liver is a rare anomaly. Research studies had mainly described the diaphragmatic sulci in the liver, however there are no research reports on the presence of AS in the inferior surface of the right lobe of the liver. The presence of the AS may represent the deep course of the hepatic veins superficially, thus proving to be more beneficial to the hepatobiliary surgeons. The AS may be due to a developmental defect, or may be acquired as a result of pressure by any superficial structure. The precise anatomical knowledge of the AS may also be important for radiologists interpreting CT images of injected veins. The gross anatomical findings of anomalous AS in 2 liver specimens, and its clinical implications are being highlighted in the present study.