What is Morison’s pouch?

Morison’s pouch is an area between your liver and your right kidney. It’s also called the hepatorenal recess or right subhepatic space.

Morison’s pouch is a potential space that can open up when fluid or blood enters the area. When these aren’t present, there’s no space between your liver and right kidney. As a result, doctors use the presence of Morison’s pouch on an ultrasound to help diagnose conditions that cause fluid buildup in your abdomen.

Keep reading to learn more about the structure of Morison’s pouch and the conditions that affect it.

Where is it?

Morison’s pouch is located between the top of your right kidney and the back-right side of your liver, where it backs up against your peritoneum.

The peritoneum is a membrane that lines your abdomen. It has two layers. The outer layer, called the parietal peritoneum, attaches to your abdominal wall. The inner layer, called the visceral peritoneum, surrounds the organs in your abdomen, including your small intestine, stomach, liver, and colon. There’s a potential space between these two layers called the peritoneal cavity.

If you don’t have an underlying health condition affecting your abdomen, you doctor won’t notice any signs of Morison’s pouch on an imaging test. It only appears when there’s extra fluid in your abdomen.

What conditions are associated with this area?

Several conditions can cause fluid to build up within your abdomen.

Ascites

Ascites refers to fluid buildup in the peritoneal cavity. This fluid can also leak into Morison’s pouch, causing it to expand.

The main symptom of ascites is visible abdominal swelling. Other potential symptoms include:

  • reduced appetite
  • pain or pressure in your abdomen
  • abdominal tenderness
  • trouble breathing

The built-up fluid can also become infected, leading to a serious condition called spontaneous bacterial peritonitis. This can cause additional symptoms of fever and fatigue.

Many things can cause ascites, but the most common ones include cirrhosis, cancer, and heart failure.

Depending on the underlying cause and your overall health, treating ascites might involve:

Hemoperitoneum

Hemoperitoneum refers to built-up blood in your peritoneal cavity, which can also get into Morison’s pouch. It can cause a range of symptoms, including:

  • abdominal pain or tenderness
  • feeling weak or shaky
  • losing color in your face and skin
  • losing consciousness

It’s caused by an injury to a nearby blood vessel, which can result from:

  • abdominal injuries
  • abdominal aneurysms
  • an opening in your stomach or intestines
  • liver damage
  • complication of fluid drainage from your abdomen
  • lying down for too long in a hospital bed
  • an ectopic pregnancy

Hemoperitoneum is considered an emergency because it can quickly become deadly. If your doctor thinks you have hemoperitoneum, they’ll quickly perform a laparotomy. This involves surgically opening your abdomen to look for the source of the bleeding. Next, they’ll drain the extra blood and remove or repair any damaged tissue.

With quick treatment, most people can recover without any major complications.

Cirrhosis

Cirrhosis refers to permanent scarring of your liver tissue. Over time, this scar tissue puts pressure on the blood vessels in your liver, which can lead to a buildup of fluid in your peritoneal cavity and Morison’s pouch.

In its early states, cirrhosis might not cause any symptoms. As it progresses, it can cause:

  • fatigue
  • jaundice
  • loss of appetite
  • nausea
  • swelling in your abdomen or legs
  • confusion
  • slurred speech
  • increased bleeding or bruising
  • unexplained weight loss
  • unusual breast growth in men
  • shrinking testicles in men

Many things can cause cirrhosis, including:

Cirrhosis isn’t reversible, treating the underlying cause can help to slow down its progression. In more advanced cases, you may need a liver transplant.

What symptoms should I watch out for?

The symptoms of having fluid in your Morison’s pouch are similar to those of many other conditions. However, because it can be a sign of a serious condition that needs quick treatment, it’s best to call your doctor right away if you notice:

  • swelling in your abdomen or legs
  • fatigue or drowsiness
  • feeling disoriented
  • weight loss not due to diet or exercise
  • pain or tenderness in your abdomen
  • bleeding or getting bruised easily
  • a fever of 101°F or higher
  • passing out (losing consciousness)

The takeaway

Morison’s pouch is a space between your liver and right kidney that only becomes significant when your abdomen swells with fluid. When this happens, your doctor will be able to see your Morison’s pouch on an ultrasound.