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Images in Surgery| Volume 161, ISSUE 4, P1174-1175, April 2017

Wandering liver

Published:March 05, 2016DOI:https://doi.org/10.1016/j.surg.2016.01.021
      This section features outstanding photographs of clinical materials selected for their educational value or message, or possibly their rarity. The images are accompanied by brief case reports (limit 2 typed pages, 4 references). Our readers are invited to sumit items for consideration.
      A 4-year-old girl was evaluated at the Emergency Department because of chronic, intermittent, vague abdominal pain and chronic constipation. On physical examination, a mobile mass was palpable in the left flank. Blood test examinations were normal. Abdominal ultrasound showed a mobile liver in the transverse plane during patient positioning. Abdominal computed tomography (CT) confirmed the normal position of the liver with the patient in supine position (Fig 1), while the position of the liver changed from the right side to the left side of the abdomen when the patient was placed in the left lateral decubitus position (Fig 2). Considering the mild symptoms and the high reported recurrence rate after hepatopexy, a “wait and see” strategy was undertaken.
      • Bauones S.
      • Hoang H.
      • Roman C.
      • Hery G.
      • Delarue A.
      • Petit P.
      • et al.
      Wandering liver: ultrasound and magnetic resonance imaging diagnosis.
      • Svensson J.F.
      • Schlinzig T.
      • Kaiser S.
      Wandering liver in a neonate: case report and review of the literature.
      At her 2-year follow-up, the patient is doing well and presents no symptoms.
      Figure thumbnail gr1
      Fig 1Abdominal CT showing the normal position of the liver with the patient in supine position.
      Figure thumbnail gr2
      Fig 2Abdominal CT showing the changing of the position of the liver from the right side to the left side of the abdomen when the patient is placed in the left lateral decubitus position. No restrictions in blood flow in the inferior caval vein, the portal vein, or the hepatic veins were noted during the change of the decubitus.
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      References

        • Bauones S.
        • Hoang H.
        • Roman C.
        • Hery G.
        • Delarue A.
        • Petit P.
        • et al.
        Wandering liver: ultrasound and magnetic resonance imaging diagnosis.
        J Pediatr Surg. 2012; 47: e21-e25
        • Svensson J.F.
        • Schlinzig T.
        • Kaiser S.
        Wandering liver in a neonate: case report and review of the literature.
        J Pediatr Surg. 2010; 45: 635-638
        • Nichols B.W.
        • Figarola M.S.
        • Standley T.B.
        A wandering liver.
        Pediatr Radiol. 2010; 40: 1443-1445