The liver is the largest internal organ and largest gland in the body, weighing about 1.5 kg in adults. It fills most of the right upper abdomen under the diaphragm and ribs and extends across the midline. It has a double blood supply: about three-quarters of its blood arrives from the gut through the portal vein and the rest, rich in oxygen, through the hepatic artery.
| Location | Right upper quadrant and epigastrium, under the right dome of the diaphragm, mostly protected by ribs 7-11, extending into the left upper quadrant |
|---|---|
| Parts |
|
| Nerve Supply | Hepatic plexus from the coeliac plexus (sympathetic); Vagus nerve (parasympathetic); Lower intercostal nerves and right phrenic nerve (capsule and covering peritoneum) |
| Blood Supply | Proper hepatic artery; Right and left hepatic arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Processes absorbed nutrients, stores glycogen, vitamins and iron, makes plasma proteins including albumin and clotting factors, produces bile, and breaks down drugs, toxins, hormones and old red cell products.
The liver is the most commonly injured solid organ in penetrating abdominal trauma and is also often damaged in blunt trauma. Chronic injury from alcohol, fatty liver disease or viral hepatitis leads to fibrosis and cirrhosis, with portal hypertension, varices, ascites and a high risk of liver cancer. Liver blood tests, clotting time and albumin reflect its function, and irritation of its capsule can refer pain to the right shoulder.
End-stage scarring of the liver with nodules that disrupts blood flow and function, causing portal hypertension, jaundice, ascites and encephalopathy.
Primary liver cancer arising mainly in cirrhotic livers or in chronic hepatitis B, monitored for by regular ultrasound in at-risk patients.
Tear of the liver from blunt or penetrating trauma, ranging from minor capsular tears to major injuries with life-threatening bleeding.
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