03/05/2022
Fat digestion and hiatal hernia: The tortuous coronary ligament widens posteriorly and encompasses the IVC. Its union with the left triangular ligament gives birth to an extension called the Arantius ligament, the place of insertion of the lesser omentum in direct connection with the stomach. Here includes the common bile duct, hepatic artery, and portal vein.
According to AT Still, “The role of the artery is absolute” - when a tissue is in a situation of lesion or in tension, the structure can be treated via understanding the links so fluid flow is not obstructed.
The same tissue that connects the liver to the diaphragm (triangular, coronary, and falciform ligaments), liver to stomach (lesser omentum), IVC and hepatic portal system (coronary and Arantius ligaments), hepatic artery and the stomach (insertion of the lesser omentum on Arantius).
All of these elements are linked - disruption of one will affect all.
This may help to explain fat digestion problems of patients with hiatal hernia, with the lesser omentum being around the hepatic hilum and putting tension on the entire vascularity and hepatobiliary intake and excretion. From this point of view, a lesion of the liver, in addition to its own repercussions on its functions, will be transmitted directly to the diaphragm and/or the stomach, and therefore the lumbar spine.