Benign Anatomical Mistakes: Right and Left Coronary Ligaments

Abstract

Peritoneal attachments of the liver to the diaphragm include the falciform ligament, the left triangular ligament, and the coronary ligament with the right triangular ligament. It is often surgically convenient when the gastroesophageal junction is explored to refer to a “right” and a “left” coronary ligament, but this is anatomically unjustified. To reassess the issue there are no “right” and “left” coronary ligaments; there are only the left triangular ligament and the complex of coronary and right triangular ligament. The latter is the lateral unification of the layers of the coronary ligament. The liver is posteriorly connected to the diaphragm, and therefore the coronary ligament has superior and inferior layers rather than anterior and posterior layers. Embryologically these ligaments reflect the remnants of the developmental pathways of the liver in the septum transversum, and in the mature organism they are peritoneal connections. Besides the liver is suspended in the bare area mostly by fibrous attachments and by the hepatic veins. Consequently the term “ligament” for these structures has to be revised. Therefore we suggest the terms “left triangular peritoneal attachment” of the liver and “coronary peritoneal attachment” instead of “left triangular ligament” and “coronary ligament.”