Case Report: Torsion of an Accessory Liver Lobe in a 6-Year-Old Girl

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  • Kawaguchi Yunosuke
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University
  • Mitsunaga Tetsuya
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University
  • Saito Takeshi
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University
  • Terui Keita
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University
  • Nakata Mitsuyuki
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University
  • Yoshida Hideo
    Department of Pediatric Surgery, Graduate School of Medicine, Chiba University

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Other Title
  • 捻転にて発症した副肝葉の1小児例
  • 症例報告 捻転にて発症した副肝葉の1小児例
  • ショウレイ ホウコク ネンテン ニテ ハッショウ シタ フクカン ヨウ ノ 1 ショウニレイ

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Abstract

<p>A 6-year-old girl was admitted to our hospital because of epigastralgia and vomiting. She was diagnosed preliminarily as having torsion of an ovarian cyst, but laparoscopic surgery showed no evidence of torsion but only a right ovarian cyst. Because she had a slight fever and epigastralgia after surgery, we performed ultrasonography and contrast-enhanced computed tomography scans, which showed a tumor at the porta hepatis. She underwent repeat surgery 37 days after the onset of symptoms because of the suspicion of gastrointestinal duplication or mesenteric lymphangioma. A 15-mm mass superior to the hepatic duct bifurcation was removed and shown histopathologically to be hepatic tissue with ischemic necrosis. The final diagnosis was accessory liver lobe with torsion. Her clinical course after surgery was good, and she was discharged 8 days after the second surgery. Accessory liver lobe is a congenital anomaly. Because accessory liver lobe does not have identifying features, it is difficult to diagnose using imaging modalities and is therefore usually diagnosed definitely at surgery or histopathologically. Accessory liver lobe is rarely detected owing to torsion, which gives rise to acute abdominal pain.</p>

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