Space
Hepatorenal recess
Dependent right subhepatic peritoneal pocket
High-yield
Fluid between liver and right kidney is a key right-upper-quadrant ultrasound finding, but a complete trauma examination evaluates several recesses rather than this pocket alone.
Overview
The hepatorenal recess lies between the inferior right liver and the peritoneum in front of the right renal/suprarenal region. It is part of the greater sac and communicates with surrounding right-sided recesses. Supine positioning makes it an important site for accumulation of free intraperitoneal fluid.
Reference facts
- Boundaries
- Right hepatic visceral surface anteriorly, peritoneum over the right kidney/suprarenal region posteriorly, and nearby duodenal/right-colic structures inferiorly.
- Contents
- Normally a potential space with a thin lubricating fluid film; pathological fluid can expand it.
- Communications
- Communicates with right subphrenic and subhepatic spaces and with the right paracolic gutter toward the lower abdomen and pelvis.
Clinical correlation
Blood, ascitic fluid or inflammatory fluid may collect here and travel through the right paracolic gutter. Fluid distribution depends on body position, volume and adhesions; a negative image of this recess does not exclude abdominal injury.
Frequently asked questions
What are the boundaries of the hepatorenal recess?
Right hepatic visceral surface anteriorly, peritoneum over the right kidney/suprarenal region posteriorly, and nearby duodenal/right-colic structures inferiorly.
What does the hepatorenal recess contain?
Normally a potential space with a thin lubricating fluid film; pathological fluid can expand it.
What does the hepatorenal recess communicate with?
Communicates with right subphrenic and subhepatic spaces and with the right paracolic gutter toward the lower abdomen and pelvis.