What is lienorenal?

September 21, 2025 •

4 min read

In medical terminology, the word 'lienorenal' is an anatomical descriptor combining the Latin 'lieno-' (spleen) and 'renal' (kidney), most famously associated with the lienorenal ligament. This key peritoneal structure is not just a simple connective tissue but a critical bridge housing important blood vessels and a portion of the pancreas.

Quick Summary

Lienorenal is an anatomical term referencing the spleen and kidney, most commonly referring to the lienorenal or splenorenal ligament, a peritoneal fold that holds the splenic vessels and pancreatic tail.

Key Points

Anatomical Link: 'Lienorenal' describes the anatomical relationship between the spleen and the kidney, primarily via the lienorenal ligament.
Critical Content: The lienorenal ligament contains the splenic artery, splenic vein, and the tail of the pancreas.
Surgical Risk: The close proximity of the pancreatic tail to the spleen makes it vulnerable to injury during procedures like a splenectomy.
Portal Hypertension: High blood pressure in the liver can cause collateral vessels to form in the lienorenal region, which can be addressed with a lienorenal shunt.
Imaging Evaluation: Medical imaging like ultrasound and CT scans are used to assess the lienorenal area for anatomical variations, vessel issues, and related pathologies.

Understanding the Lienorenal Ligament

The most common application of the term lienorenal is in reference to the lienorenal ligament, also known as the splenorenal ligament. This is a double layer of peritoneum, which is the membrane that lines the abdominal cavity, that connects the hilum (the indented surface) of the spleen to the front surface of the left kidney. It forms part of the greater omentum and serves as a vital anchor for the spleen, securing it in place within the upper left quadrant of the abdomen. Anatomically, it also forms the lateral border of the lesser sac, a smaller peritoneal compartment behind the stomach.

Contents of the Lienorenal Ligament

Within the two layers of this ligament lie several crucial structures that are of significant importance to surgeons.

Splenic Vessels: The ligament acts as a pathway for the splenic artery and vein, which supply and drain the spleen, respectively. The splenic artery originates from the celiac trunk and runs along the upper border of the pancreas, and the splenic vein joins the superior mesenteric vein to form the portal vein.
Tail of the Pancreas: The tail of the pancreas, which is the narrowest and most mobile part of the organ, is also situated within the lienorenal ligament and is the only portion of the pancreas that is completely intraperitoneal. This anatomical relationship is critically important during surgical procedures involving the spleen.

Anatomical Variations and Clinical Risks

Anatomical variations of the lienorenal ligament and the position of the pancreatic tail are common and pose a significant risk during surgical interventions like a splenectomy (removal of the spleen). If the tail of the pancreas is positioned very close to or within the splenic hilum, it is vulnerable to damage, which can lead to severe postoperative complications such as pancreatic fistulas or pancreatitis. This is why a surgeon’s meticulous understanding of the lienorenal anatomy is essential before operating in this area.

The Clinical Spectrum of Lienorenal Conditions

While the lienorenal ligament itself is generally stable, its surrounding structures and contained vessels can be affected by various health conditions.

Lienorenal Shunts and Portal Hypertension

Portal hypertension, often caused by severe liver disease (cirrhosis), leads to high blood pressure in the portal venous system. When this occurs, the body develops collateral vessels to decompress the system. One of the main pathways for these collaterals is through the lienorenal area, where blood can be shunted from the splenic vein to the left renal vein. In cases of refractory variceal bleeding or when other treatments fail, a surgical procedure known as a splenorenal shunt (or lienorenal shunt) can be performed to create a permanent bypass to relieve pressure. Side-to-side lienorenal shunts without splenectomy are a surgical option, particularly for non-cirrhotic portal hypertension, and have shown good long-term outcomes.

Related Conditions and General Health Considerations

Disorders of either the spleen or kidney can have a clinical impact on the lienorenal area.

Splenomegaly: An enlarged spleen, or splenomegaly, can be caused by infections (mononucleosis), liver disease (cirrhosis), and blood cancers. A massively enlarged spleen can put pressure on the kidney.
Wandering Spleen: A rare condition where a congenital absence or weakness of the suspensory ligaments (including the lienorenal ligament) allows the spleen to migrate from its normal position. This can lead to vascular torsion, compromising blood flow and causing ischemia.
Kidney Disease: While not directly linked to the lienorenal ligament, kidney diseases can affect overall health, and inflammation (like in some glomerular diseases) can present as flank or loin pain, potentially in the same region.

Comparison of Peritoneal Ligaments


Feature	Lienorenal Ligament	Gastrosplenic Ligament
Function	Connects the spleen's hilum to the left kidney; carries the splenic vessels and pancreatic tail.	Connects the greater curvature of the stomach to the splenic hilum; contains the short gastric and left gastroepiploic vessels.
Structures Contained	Splenic artery and vein, tail of the pancreas.	Short gastric arteries and veins, left gastroepiploic vessels.
Surgical Importance	Critical during splenectomy due to potential risk to the pancreatic tail and splenic vessels.	Access point to the lesser sac and important during stomach or spleen surgery.
Anatomical Role	Defines the lateral border of the lesser sac.	Part of the greater omentum and lateral boundary of the lesser sac.

Medical Imaging and Diagnosis

Non-invasive imaging techniques like ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are crucial for evaluating the lienorenal region. Ultrasound with color Doppler can assess blood flow, detect splenic vessel thrombosis, or identify collateral circulation in portal hypertension. CT and MRI provide detailed anatomical views, helping to identify the exact location of the pancreatic tail and any associated pathologies, which is essential for pre-surgical planning.

Conclusion

In conclusion, what is lienorenal is a question answered by understanding the vital lienorenal ligament, a complex anatomical structure linking the spleen and left kidney. Its role in anchoring the spleen and housing critical vessels and the pancreatic tail underscores its clinical importance, particularly in surgical scenarios and conditions like portal hypertension. Knowledge of its normal anatomy and potential variations is paramount for medical professionals to prevent complications and ensure optimal patient outcomes. The lienorenal ligament is far more than a simple anatomical term; it is a critical intersection in the complex network of human health, highlighting the interconnectedness of our internal organs.

Further reading on the clinical importance of this area can be found in the anatomical studies referenced in medical journals, such as this overview of lienorenal shunt techniques for portal hypertension: Side-to-side lienorenal shunt without splenectomy in portal obstruction, extra hepatic.

Frequently Asked Questions

The primary function is to serve as a suspensory anchor for the spleen, securing it to the posterior abdominal wall at the level of the left kidney. It also provides a protective pathway for the splenic artery and vein.

There is no difference in meaning; they are synonymous terms. 'Lieno-' and 'spleno-' are both prefixes derived from Latin and Greek, respectively, for the spleen. Both terms refer to the anatomical connection between the spleen and the kidney.

Surgeons must be aware of the ligament's anatomy, especially the tail of the pancreas contained within it. Damage to the pancreatic tail or splenic vessels during surgery, particularly splenectomy, can lead to severe complications like pancreatic fistulas.

In portal hypertension, increased pressure in the portal venous system can cause blood to be diverted through alternative pathways. This often involves forming collateral veins in the lienorenal region, allowing blood to flow from the splenic vein to the left renal vein.

A lienorenal shunt is a surgical procedure, also known as a splenorenal shunt, that creates a connection between the splenic vein and the left renal vein. This is done to relieve the high pressure caused by portal hypertension.

While the ligament itself is not typically a site of primary disease, conditions like portal hypertension can cause collateral vessel formation within it. Additionally, a rare 'wandering spleen' can occur if the ligament is congenitally weak or absent.

Radiographic imaging methods such as ultrasound, CT scans, and MRI are used to visualize the lienorenal anatomy. These scans can help identify anatomical variations, assess blood flow, and detect pathologies like enlarged spleens or collateral vessels.