The hepatorenal recess (subhepatic recess, pouch of Morison or Morison's pouch) is the subhepatic

space Space is the boundless three-dimensional extent in which objects and events have relative position and direction. In classical physics, physical space is often conceived in three linear dimensions, although modern physicists usually cons ...

that separates the

liver The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it ...

from the right

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...

. As a

potential space In anatomy, a potential space is a space between two adjacent structures that are normally pressed together (directly apposed). Many anatomic spaces are potential spaces, which means that they are potential rather than realized (with their realiz ...

, the recess is not normally filled with fluid. However, fluid can collect here in circumstances where the abdomen fills with fluid, such as

hemoperitoneum Hemoperitoneum (also haemoperitoneum, sometimes also hematoperitoneum) is the presence of blood in the peritoneal cavity. The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Hemope ...

. This fluid may be seen on

ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...

or computed tomography (CT scan).

Clinical importance

Since it is a

, the hepatorenal recess is not normally filled with fluid. However, this space becomes significant in conditions in which fluid collects within the abdomen (most commonly

ascites Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, a ...

and

). The intraperitoneal fluid, be it blood, ascites, or

dialysate In chemistry, dialysis is the process of separating molecules in solution by the difference in their rates of diffusion through a semipermeable membrane, such as dialysis tubing. Dialysis is a common laboratory technique that operates on the ...

, collects in this space and may be visualized, most commonly via

or computed tomography (CT) scanning. As little as 30 or 40 ml of fluid in the abdominal cavity may be visualized in this space. Early visualization of fluid in the hepatorenal recess on FAST scan may be an indication for urgent

laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ane ...

Etymology

The hepatorenal recess is also called the ''pouch of Morison'', or ''Morison's pouch'', after the

British British may refer to: Peoples, culture, and language * British people, nationals or natives of the United Kingdom, British Overseas Territories, and Crown Dependencies. ** Britishness, the British identity and common culture * British English, ...

surgeon James Rutherford Morison.

Additional images

File:Morrisons-normal.jpg, A normal ultrasonographic view of Morison's pouch. The bright line is the capsule of the kidney; there is no fluid present and hence no visible space. File:MorisonNoText.png, Ultrasound of liver (left side of the image) and right kidney (right side of the image) and Morison's pouch, not containing fluid. File:CT abdomen - liver cirrhosis - 01.JPG, Abdominal CT, showing Morison's pouch as the dark margin surrounding the right kidney (at lower left corner of image). File:Morison003.jpg, Ultrasonographic view of the abdomen demonstrating fluid within Morison's pouch. File:Ultrasound Scan ND 0110145312 1506110.png

References

{{Authority control Abdomen