Morison's pouch
Encyclopedia
The hepatorenal recess or subhepatic recess is the space that separates the liver
from the right kidney
. As a potential space
, the recess is not filled with fluid under normal conditions. However, fluid can collect in this space in circumstances where the abdomen fills with fluid, such as hemoperitoneum
. This fluid may be seen on ultrasound
or computed tomography
(CT scan).
, 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
and hemoperitoneum
). The intraperitoneal fluid, be it blood, ascites, or dialysate, collects in this space and may be visualized, most commonly via ultrasound
or computed tomography
(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
.
surgeon James Rutherford Morison
.
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
from the right kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
. As a potential space
Potential space
In anatomy, potential space refers to a space or cavity that can exist because two adjacent features that are not tightly adjoined, but does not appear during normal functioning.-Examples:* subdural space* vagina* pericardial cavity...
, the recess is not filled with fluid under normal conditions. However, fluid can collect in this space in circumstances where the abdomen fills with fluid, such as hemoperitoneum
Hemoperitoneum
Hemoperitoneum 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. Hemoperitoneum is generally classified as a surgical emergency; in most cases, urgent laparotomy is needed to...
. This fluid may be seen on ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or computed tomography
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
(CT scan).
Clinical importance
Since it is a potential spacePotential space
In anatomy, potential space refers to a space or cavity that can exist because two adjacent features that are not tightly adjoined, but does not appear during normal functioning.-Examples:* subdural space* vagina* pericardial cavity...
, 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
Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...
and hemoperitoneum
Hemoperitoneum
Hemoperitoneum 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. Hemoperitoneum is generally classified as a surgical emergency; in most cases, urgent laparotomy is needed to...
). The intraperitoneal fluid, be it blood, ascites, or dialysate, collects in this space and may be visualized, most commonly via ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or computed tomography
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
(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 for trauma
Focused Assessment with Sonography for Trauma is a rapid bedside ultrasound examination performed by surgeons and emergency physicians as a screening test for blood around the heart or abdominal organs after trauma.The four areas that are examined for free fluid are the perihepatic space...
may be an indication for urgent laparotomy
Laparotomy
A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.- Terminology :...
.
Name
The hepatorenal recess is also called the pouch of Morison (or Morison's pouch) after the BritishGreat Britain
Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...
surgeon James Rutherford Morison
James Rutherford Morison
James Rutherford Morison was a British surgeon who was a native of County Durham. In 1874, he graduated from the University of Edinburgh, and as a young man was an assistant and "surgical dresser" to Joseph Lister . Later, he became a surgeon at the Newcastle Royal Infirmary and a professor at the...
.