VARIATIONS IN LIVER COLON ANATOMIC RELATIONSHIP - RELEVANCE TO INTERVENTIONAL RADIOLOGY

PURPOSE: To determine the prevalence of significant variations in live r-colon anatomy in an unselected patient population and evaluate the p otential effect of these variations on liver-related interventional pr ocedures. PATIENTS AND METHODS: All abdominal computed tomographic (CT ) scans were reviewed prospectively over a 4-month period. Cases that revealed variant hepatocolic anatomy were selected and analyzed for th e position of the colon, gallbladder, and duodenum; liver morphology; and the anatomic relations of the right portal vein. RESULTS: Seventee n (3.3%) of 517 abdominal CT scans demonstrated variant hepatocolic an atomic relations. In seven cases, liver lobar morphology was normal, b ut the colon was interposed between the chest wall and the liver. The remaining 10 cases were characterized by hypoplasia or aplasia of one or both segments of the left lobe. In these cases the right portal vei n was anteriorly exposed and was close to the gallbladder and transver se colon. In all 17 cases it was qualitatively judged that technical m odifications might be needed in the performance of various interventio nal procedures, including percutaneous biliary drainage, biopsies, and transjugular intrahepatic portosystemic shunt creation. CONCLUSION: V ariations in liver-colon anatomic relations in isolation or secondary to hepatic developmental anomalies may have a significant potential im pact on the performance of various fluoroscopically guided hepatobilia ry interventional procedures.