Sonographic characterization of an accessory fissure of the left hepatic lobe determined by omental infolding.

This article describes the sonographic appearance of a very common accessory fissure of the liver located on the inferior side of the left lobe. The fissure was recognized in about 5% of 800 consecutive subjects and showed variable appearance owing to different insertion levels on the inferior hepatic surface. It extended from the left hepatic border to the Rex's recess or alternatively to the falciform ligament or the gallbladder fossa and contained the hepatogastric and hepatoduodenal ligaments, as demonstrated by laparotomy in six cases. At surgery, there was no evidence of thickening of Glisson's capsule at the fissure site, thus suggesting that the fissure is the result of extrinsic remodeling of the left lobe by omental infolding.