Congenital malformations of the liver are not common. There are cases' of absence of the liver, and of defect of one of the lobes or irregularity in the lobes. What may be called supernumerary livers have also been found in the form of isolated pieces of liver tissue in the suspensory ligament. Of more importance is congenital absence of the gall bladder, along with which there is usually a dilatation of the bile ducts.

The liver is sometimes Transposed along with a general transposition of the viscera. In a case recorded by Fraser, there was not only a transposition but an occasional Dislocation of the liver, which came down into the left inguinal region.

An Acquired deformity is the so-called Stay liver of females. This deformity is usually stated to be due to tight lacing, but although doubtless greatly aggravated by this, it is also induced by the ordinary methods of suspending the garments by a tight ligature round the waist. The effect on the liver is that it is greatly flattened, while a transverse shallow depression forms along the upper surface, affecting chiefly the right lobe. In this groove the capsule is thickened, and there is obviously considerable loss of liver tissue. Sometimes the atrophy along this groove is such that the two portions can be folded together. With the flattening there is great displacement of the liver, whose lower edge may extend as far down as the umbilicus. More or less of this deformity is to be found in nearly all female bodies, and also in the bodies of men who have been in the habit of wearing tight belts round their waists.

Sometimes the upper surface of the right lobe of the liver presents elongated depressions passing from behind forwards, which are really Folds of the liver, and are produced chiefly when there is some obstruction to expiration. In that case the diaphragm is depressed by the dilated lung, and at the same time the lower ribs are drawn down in violent expiratory movements by the abdominal muscles, and pressed against the liver,which is supported below by the contraction of the abdominal muscles.

The liver is very liable to Changes of position. Tumours or fluid in the abdomen carry it upwards. Depressions of the diaphragm press it downwards. The suspensory ligament may be elongated so that the organ is unduly movable, and may undergo displacement downwards.

Literature

Thierfelder, in Ziemssen's Cycl., ix., 1887; Laudau, Wanderleber und Hangebauch der Frauen, 1885; Fraser, Glasg. Med. Jour., xx., 1883.