Ectopic liver discovered during laparoscopic cholecystectomy
Ectopic liver is defined as liver tissue that has no hepatic connection and is located outside the liver. It is also referred to as choristoma. According to statistics, the incidence rate of the condition is less than 1%. The liver tissue can occur in several organs, with the gallbladder as the commonest site of origin.
In a similar case, a 47-year-old Saudi patient presented with a 2-month history of right upper quadrant pain. There were no complaints of nausea, vomiting or change in urine or stool colour. He had no history of medical illness or surgery. His medical history revealed that he had undergone treatment for Helicobacter pylori infection. However, showed no improvement. On examination, there were no relevant findings other than a tender right upper quadrant. Doctors further advised laboratory tests which were all within normal limits. Serology results for hepatitis B, C and HIV were also negative.
The patient was also referred for an ultrasound of the abdomen which showed a calcular gallbladder with a slightly thickened wall, measuring 5 mm. There was no evidence of focal lesion or intrahepatic biliary dilation. CBD and the portal vein were also within the normal range. A week after completing the treatment for H. pylori, the patient was called for a follow-up a week later. According to the patient, he was still in pain, bloated and had a decreased appetite. His physical examination did not show any significant findings. Further tests ruled out the presence of Helicobacter antigen in the stool and occult blood.
The patient was then referred for surgical management for acute cholecystitis and chronic cholecystitis
In March 2011, the patient voluntarily admitted himself for laparoscopic cholecystectomy. The patient was given prophylactic antibiotics. Doctors intubated and ventilated the patient mechanically. He had an uneventful recovery period. He was started on a low-fat diet six hours after surgery. The patient stayed at the hospital for 1 day with no signs of postoperative symptoms. Similarly, he had no signs of nausea or vomiting.
2 weeks after the procedure, the patient was called for a routine follow-up. On examination, he had no symptoms and the surgical wounds were clean and dry. Histological examination of the gallbladder showed extensive ulceration of the mucosa and wall, with inflammation, however, with no signs of malignancy. Doctors diagnosed the patient with chronic calcular cholecystitis with normal EL architecture, with no dysplasia or malignancy.
Source: American Journal of Case Reports
