Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Sep 26:10:970876.
doi: 10.3389/fped.2022.970876. eCollection 2022.

Case report: A case of giant accessory hepatic lobe torsion combined with left hepatic vein branch thrombosis in a child

Xiangang Xiong  1   2 , Yonghua Lou  3 , Teng Zhou  1   2 , Zebing Zheng  1   2 , Yuanmei Liu  1   2 , Rui Liu  1   2 , Kaizhi Zhang  1   2 , Yuan Gong  1   2 , Chengyan Tang  1   2 , Zhu Jin  1   2
Affiliations
Case Reports

Case report: A case of giant accessory hepatic lobe torsion combined with left hepatic vein branch thrombosis in a child

Xiangang Xiong et al. Front Pediatr. .

Abstract

The accessory hepatic lobe (AHL) is a rare congenital malformation of the hepatic tissue, among which the giant AHL is the rarest in children. Patients without complications are usually asymptomatic, and most auxiliary examinations cannot provide a definitive preoperative diagnosis. Surgical procedure is the only recommended management for patients who suffered from the complications of AHL. We report the case of a rare pediatric giant AHL torsion combined with left hepatic vein branch thrombosis which was successfully treated by laparoscopic lobectomy followed by excision of AHL.

Keywords: accessory hepatic lobe; accessory hepatic lobe torsion; child; left hepatic vein branch thrombosis; liver.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A,B) Cross-sectional images of the first enhanced CT scan before admission on 25 April 2021 show 180° torsion of the left hepatic artery (arrow); (C) On 27 April 2021, compared with the previous CT scan, the enhanced CT scans repeated after the disappearance of abdominal pain symptoms suggested that the twisted hepatic artery has reset itself (arrows). LHA, left hepatic artery; CT, computed tomography.
FIGURE 2
FIGURE 2
(A) Coronal image of the enhanced CT scan on 27 April 2021 revealed the mass was visible as non-uniform reinforcement in the inferior portion; (A,B) CTA images illustrated that the left hepatic artery, the branch of the left hepatic vein, and the left branch of the portal vein were observed within the mass, but multiple filling defects are recognized inside the branch of the left hepatic vein. AHL, accessory hepatic lobe; TH, thrombosis; L, liver; LPV, left hepatic portal vein; BLHV, the branch of the left hepatic vein; LHA, left hepatic artery.
FIGURE 3
FIGURE 3
(A) Intraoperative images suggested the AHL has repositioned itself, with only a stalk of approximately 2 cm in diameter liver tissue forming an attachment to the left liver. (B,C) Excision of large AHL with thrombosis of a branch of the left hepatic vein. (D) The histopathology result demonstrated the irregular structure of the hepatic lobules, dilated hepatic sinusoids, and disordered vascular distribution in the portal area and interlobular. AHL, accessory hepatic lobe; S, stalk; TH, thrombosis; BLHV, branch of the left hepatic vein.
See this image and copyright information in PMC

References

    1. Umehara M, Sugai M, Kudo D, Hakamada K, Sasaki M, Munakata H. Torsion of an accessory lobe of the liver in a child: report of a case. Surg Today. (2009) 39:80–2. 10.1007/s00595-008-3772-0 - DOI - PubMed
    1. Khan AM, Hundal R, Manzoor K, Dhuper S, Korsten MA. Accessory liver lobes: a diagnostic and therapeutic challenge of their torsions. Scand J Gastroenterol. (2006) 41:125–30. 10.1080/00365520500377862 - DOI - PubMed
    1. Azmy A, Boddy SA, Eckstein HB. Torsion of gall bladder, embedded in an accessory lobe of liver in a neonate with Beckwith syndrome. Z Kinderchir Grenzgeb. (1980) 30:277–9. 10.1055/s-2008-1066372 - DOI - PubMed
    1. Corbitt N, Rellinger EJ, Hernanz-Schulman M, Chung DH. Accessory hepatic lobes in the pediatric population: a report of three cases of torsion and literature review. J Pediatr Surg Case Rep. (2017) 16:15–8. 10.1016/j.epsc.2016.09.003 - DOI
    1. Nagano A, Onishi S, Kedoin C, Matsui M, Murakami M, Sugita K, et al. A rare case of accessory liver lobe torsion in a pediatric patient who showed recurrent epigastralgia and who was treated by elective laparoscopic resection. Surg Case Rep. (2021) 7:143. 10.1186/s40792-021-01231-6 - DOI - PMC - PubMed

Publication types

LinkOut - more resources