There were then two pouches communicating with the two abdominal cavities, arranged one above another in the band, Chang’s being the lower of the two. No remains of an umbilical vein were detected, nor was there any communication between the pouches and the umbilicus. It has already been noticed that the round ligament of each liver passed from the longitudinal fissure to a scar on the anterior wall of the abdomen near the band. It was not, therefore, within the round ligaments, but the folds of the suspensory ligaments, that the pouches were found.
Eng’s pouch measured 2-1/2 in. From edge of Chang’s suspensory ligament to end of hepatic pouch measured 3 in.
Extending across the band, about midway between the properties of the two individuals, was a septum. It was attached above and below to the respective boundaries of the band, and along its entire length was incorporated with its two peritoneal cavities, so that when in the course of the dissection of the “posterior” surface of the band the peritoneal covering of the band was displayed, several large lobules of fat were seen lying to Eng’s side of the septum.[[4]]
It will be seen that Fig. [8] represents the band opened to display the pouches with the septum. The lower end of the septum is fixed near the scar of the umbilicus, and holds an immobile position over the umbilical pouches. At this point it is free from fat. But as it extends over the hepatic pouches it is more pliant. This portion of the septum has been carried a little to Chang’s side of the band to display the entire length of the hepatic pouch of Eng.
Figs. [9] and [10] are designed to exhibit the appearances presented in securing views of the septum from its sides. Fig. [9] is the side toward Chang, and Fig. [10] is the side toward Eng.
Fig. 8. The surface, C. R., E. L., showing the interior of band by free division of the aponeuroses seen in Fig. [7], and their underlying peritoneal attachments. A. The orifice of umbilical pouch of Eng. B. The orifice of umbilical pouch of Chang, showing connection with suspensory ligament of Eng. C. The fenestrated umbilical pouch of Eng passing between the folds of the suspensory ligament of Chang. D. Suspensory ligament of liver of Eng. E. Hepatic tract. F. Hepatic pouch of Eng. G. The septum.
The pouches and septum were now removed and the position of the hepatic tract determined. It rested upon the incurved borders of the ensiform cartilages (see Fig. [15]), and as the subject lay on the table with the “posterior” surfaces of the band exposed (Fig. [11]) the hepatic tract was slightly arched. It measured three inches in length, was compressed, and measured six lines wide and three lines thick. The tract arose from the livers at the same point—namely, directly above the longitudinal fissure, having more fulness on the side of the right than of the left lobe. The round ligament, as it passed out of the longitudinal fissure of each liver, was placed beneath and a little to the left of the tract.
Fig. 9. The septum viewed from Chang’s side. A. The orifice of umbilical pouch of Chang. B. The orifice of the hepatic pouch of Chang. C. Suspensory ligament of Chang containing umbilical pouch of Eng.