Abstract
Purpose
The aim of the present communication was to describe an accessory hepatic lobe in two patients and to outline the significance of the timely identification of this very rare anatomic variation for the clinical practice.
Methods
In the course of right hemihepatectomy, accessory liver lobes were detected in two patients. Their diagnosis was confirmed by histopathology and cholangiography.
Results
Both accessory hepatic lobes arose from the left liver segments. The first lobe was detected in a 56-year-old male operated on for a retroperitoneal liposarcoma. It amounted to 15% of the standard liver volume and was attached to liver segments 2 and 3 by a stalk. The second accessory lobe was found out in 45-year-old female operated on for a colon cancer and synchronous liver metastases. It was less than 15 g in weight and attached to the main liver by a mesentery as its bile duct drained into an extrahepatic duct.
Conclusions
The accessory hepatic lobes require timely diagnosis. They should be kept in mind in cases with acute surgical abdomen.
Similar content being viewed by others
References
Anand SS, Chauhan MS (2002) Intrathoracic accessory lobe of the liver. Int J Nucl Med 17:44–45
Bingham JB, Maisey MN (1978) Unusual scintigraphic appearance of a mobile accessory lobe of the liver. J Nucl Med 19:1235–1237
Carrabetta S, Piombo A, Podestá R, Auriati L (2009) Torsion and infarction of accessory liver lobe in young man. Surgery 145:448–449
Caygill CP, Gatenby PA (2004) Ectopic liver and hepatocarcinogenesis. Eur J Gastroenterol Hepatol 16:727–729
Choi SU, Kim HK, Kim J (2008) Heterotopic supradiaphragmatic liver combined with intralobar pulmonary sequestration. Ann Thorac Surg 85:1809–1810
Elmasalme F, Aljudaibi A, Matbouly S, Hejazi N, Zuberi MS (1995) Torsion of an accessory lobe of the liver in an infant. J Pediatr Surg 30:1348–1350
Fraser CG (1952) Accessory lobes of the liver. Ann Surg 135:127–129
Gaber M (1980) Accessory liver containing metastatic tumour. Virchows Arch A Pathol Anat Histol 385:361–364
Han S, Soylu L (2009) Accessory liver lobe in the left thoracic cavity. Ann Thorac Surg 87:1933–1934
Hundal RS, Ali J, Korsten MA, Khan AM (2006) Torsion and infarction of an accessory liver lobe. Z Gastroenterol 44:1223–1226
Ito F, Ando H, Watanabe Y, Seo T, Murahashi O, Harada T, Kaneko K, Ishiguro Y (1999) An accessory lobe of the liver disturbing closure of the umbilical ring. Pediatr Surg Int 15:394–396
Jambhekar K, Pandey T, Kaushik C, Shah HR (2010) Intermittent torsion of accessory hepatic lobe: an unusual cause of recurrent right upper quadrant pain. Indian J Radiol Imaging 20:135–137
Johnstone G (1965) Accessory lobe of liver presenting through a congenital deficiency of anterior abdominal wall. Arch Dis Child 40:541–544
Koumanidou C, Nasi E, Koutrouveli E, Theophanopoulou M, Hilari S, Kakavakis K, Batakis N (1998) Torsion of an accessory hepatic lobe in a child: ultrasound, computed tomographic, and magnetic resonance imaging findings. Pediatr Surg Int 13:526–527
Ladurner R, Brandacher G, Mark W, Iannetti C, Lottersberger C, Steurer W, Königsrainer A, Margreiter R (2005) Complete hepatic ischemia due to torsion of a large accessory liver lobe: first case to require transplantation. Transpl Int 18:467–469
Massaro M, Valencia MP, Guzman M, Mejia J (2007) Accessory hepatic lobe mimicking an intra-abdominal tumor. J Comput Assist Tomogr 31:572–573
Negru D, Tudorache C, Marinescu M, Grigoraş M, Crumpei F, Georgescu S (2007) Torsion and infarction of an accessory liver lobe. Rev Med Chir Soc Med Nat Iasi 111:442–445 (in Romanian)
Parke WW, Settles HE, Bunger PC, Van Demark RE (1996) Malformations of the liver: some prenatal and postnatal developmental aspects. Clin Anat 9:309–316
Pereira RM, Simões E, Silva AC, Rios Leite VH, Duarte Lanna JCB, Guimarães JT (2005) Successful management of concomitant omphalocele, accessory hepatic lobe, and biliary atresia in a 44-day-old boy. J Pediatr Surg 40:E21–E24
Pérez-Martínez A, Conde-Cortés J, Martínez-Bermejo MA, Bento-Bravo L (2006) Torsion of a pedunculated accessory hepatic lobe: differential diagnosis of projectile vomiting in a neonate. J Perinat Med 34:248–249
Pujari BD, Deodhare SG (1976) Symptomatic accessory lobe of liver with a review of the literature. Postgrad Med J 52:234–236
Rougemont AL, Sartelet H, Oligny LL, Bensoussan A, Yazbeck S, Fournet JC (2007) Accessory liver lobe with mesothelial inclusion cysts in an omphalocele: a new malformative association. Pediatr Dev Pathol 10:224–228
Sato S, Watanabe M, Nagasawa S, Niigaki M, Sakai S, Akagi S (1998) Laparoscopic observations of congenital anomalies of the liver. Gastrointest Endosc 47:136–140
Vakili K, Pomfret EA (2008) Biliary anatomy and embryology. Surg Clin N Am 88:1159–1174
Acknowledgments
The authors have greatly appreciated the critical suggestions of one anonymous reviewer enabling the improvement of their manuscript.
Conflict of interest
The authors declare that they have no conflict of interest and that they were not sponsored by any way for this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kostov, D.V., Kobakov, G.L. Accessory hepatic lobe. Surg Radiol Anat 33, 819–822 (2011). https://doi.org/10.1007/s00276-011-0818-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-011-0818-6