Laparoscopic hepatopexy: a new surgical approach to hepatoptosis in an 11-year-old boy

Wandering liver, spleen, and kidney: what the radiologist needs to know

The wandering spleen, wandering liver, and wandering kidney are rare diagnoses that can be asymptomatic or are associated with nonspecific symptoms, making the clinical diagnosis elusive. In addition, given the small number of cases, these conditions are not well understood. Major complications of wandering spleen result from torsion of the vascular pedicle with resultant ischemia, physiologic dysfunction, and/or infarction. Wandering liver is commonly associated with bowel obstruction, particularly colonic volvulus, with very rare reports of hepatic ischemia or infarct. Wandering kidneys are not commonly associated with serious complications. In many cases, the wandering spleen, liver or kidney can be found in their anatomic position on static imaging and are only diagnosed during ultrasound or with serial radiographic or cross-sectional imaging with different patient positioning, or with prior studies demonstrating different locations of the involved organ. Treatment approaches for uncomplicated wandering spleen, liver, or kidney include watchful waiting and splenopexy, hepatopexy, or nephropexy, respectively. Complicated wandering spleens are treated with splenectomy. Given the variable clinical presentation of these conditions, imaging plays a pivotal role in diagnosing these rare and often incidentally discovered phenomena.

A wandering folded liver displaced by the distended bowel: a new case report with review of the literature

INTRODUCTION

The wandering liver is an extremely rare condition in which the liver moves significantly or 'wander' with changes in patient's lie. This is believed to be an acquired condition perhaps precipitated by persistent congenital ventral mesogastrium which acts as an axis or a mesentery for the liver to rotate. The vast majority of reported cases were associated with other chronic abnormalities of the gastrointestinal tract, especially sigmoid volvulus.

PATIENTS AND METHODS

We present a case report of an acquired isolated transposition of the liver with a review of the English-language literature of wandering liver in adults and paediatric age group.

RESULTS AND CONCLUSIONS

The clinical presentation of wandering liver is variable. Most of the reported cases were asymptomatic and are usually diagnosed while having investigation or surgery for other reasons, especially the commonly associated bowel problems. However, some patients may present with intermittent jaundice and abdominal pain secondary to the abnormal liver configuration. Due to the scarcity of the condition, the diagnosis can be challenging and improper concerns of permanent liver failure is possible. Hepatopexy is usually required for symptomatic patients with good results.

Wandering liver: ultrasound and magnetic resonance imaging diagnosis

"Wandering liver" describes an excessive mobility of the liver caused by abnormalities of hepatic fixation that could lead to hepatic pedicle torsion or bowel obstruction. It is considered a rare entity, but because of the evolution in medical imaging techniques, this unusual condition is being identified more often. We report 2 cases presenting with chronic vague abdominal pain, diagnosed by abdominal ultrasonography and the use of cine-magnetic resonance imaging sequences with dynamic maneuvers. We tried to correlate our ultrasound and magnetic resonance imaging findings to peroperative findings and insist on the usefulness of dynamic maneuvers when confronted with atypical symptoms and a normal abdominal ultrasound scan finding.