Anomalous ligamentum teres: A cadaveric study with clinical implications

Objective: To study the anomalous ligamentum teres and discuss its clinical implications. Method: Ligamentum teres (LT) was studied in forty gross specimens of liver over a period of five years. The topographical anatomy of the LT was studied, the abnormalities were noted and the specimen was photographed. Result: Out of forty specimens studied, only one specimen showed the LT to be located at a distance of 5 cm to the left of midline (2.5%). As a result of the LT being situated more towards the left, the quadrate lobe was also situated more towards the left. The groove for the LT was incomplete vertically with the lower 7.5 cm being very prominent and the upper part submerged inside the tissue of the liver. The groove for the LT was located at a distance of 10 cm from the fossa for the gall bladder. The thickness of the LT measured 3 cm and the liver weighed 1.2 kilograms in weight. Conclusion: The anomalous position of the LT may result in erroneous interpretation of the liver lobes. Often the surgeon operating on gall bladder may be mistaken by anomalous position of the LT. The abdominal surgeries require proper anatomical knowledge of the LT and the falciform ligament. The LT is also visualized on normal radiographs and such anomalies are important for radiologists in day to day clinical practice.