A Case of Ectopic Liver Tissue Adherent to the Gallbladder

Eoghan B, Ilona A and Gerrard O'Donoghue

Department of Surgery, University Hospital Waterford, Ireland

^*Correspondance to: Gerrard O′Donoghue 

 PDF  Full Text DOI: 10.25107/2474-1647.1770

Abstract

We report a case of a 30 year old lady who presented to the emergency department with a one day history of severe epigastric pain which radiated to the back. On physical exam she was mildly tender in the epigastrium and right hypochondrium. Labs were notable for an amylase of 1297 U/L. Ultrasound abdomen noted multiple small gallstones in the gallbladder but no wall thickening or intra/extra hepatic bile duct dilatation. She was diagnosed with a gallstone pancreatitis and managed conservatively on initial presentation. She was discharged the following day and underwent elective laparoscopic cholecystectomy as an outpatient. During the laparoscopic surgery, a month later, a small nodule was found loosely adherent to the gallbladder serosa. Histology revealed this to be a portion of anatomically normal liver parenchyma also referred to as Ectopic Liver Tissue (ELT). Ectopic Liver Tissue is a rare developmental abnormality in which normally functioning liver tissue develops at an extra-hepatic site and has no connection to the true liver, in contrast to the accessory lobe of the Liver which has an anatomical connection to the liver proper. ELT has been reported in multiple intra-abdominal and thoracic sites including the kidneys, heart and pleural cavity. The incidence of ELT is debated and widely felt to be underestimated. ELT rarely presents symptomatically, as in our case, and is often diagnosed at autopsy or following surgery for another reason. However because of the increased risk of hepatocellular carcinoma associated with ELT we believe it to be an important congenital abnormality.

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Cite the article

Eoghan B, Ilona A, O′Donoghue G. A Case of Ectopic Liver Tissue Adherent to the Gallbladder. Clin Surg. 2017; 2: 1770.