Hypoplasia of the Right Hepatic Lobe Combined with a Floating Gallbladder

Abstract

Agenesis or hypoplasia of the right hepatic lobe combined with a floating gallbladder is an extremely rare condition. We report a case of hypoplasia of the right hepatic lobe, discovered in a 65-year old female. This was an incidental finding at CT scan for staging of a right colonic cancer. The CT evidenced the presence of a hypoplastic right lobe, while the left lobe was diffusely enlarged. Furthermore, the gallbladder was described as floating with partially calcified walls. The diagnosis of this rare anomaly was confirmed intraoperatively. The patient underwent right hemicolectomy and cholecystectomy. Biopsies were taken from both right and left hepatic lobes, revealing the presence of normal hepatic parenchyma. Since all causes of acquired atrophy of the liver had been ruled out, we considered this case to be of congenital origin.

Incidence of Floating / Wandering Gall Bladders: a Cadaveric Study and Its Clinical Implications

“…In the other case as the peritoneal fold was short and the gallbladder fossa had greater depth the chances of it under going torsion are less. Kabaroudis A et.al., [10] reported the incidence of a floating gall bladder in a 65 year old female. The liver showed hypoplasia of the right hepatic lobe.…”

Agenesis of Right Lobe of Liver; A Rare Anomaly- A Case Report

“…6,16 Anatomical variations of liver are common and occur during normal development of the organ and correspond to the variation in the distribution of liver territories. 6,16 Lobar agenesis is defined as congenital absence of or incomplete development of liver tissue of the right or left hepatic lobe without prior surgery or hepatic disease 11,16 but the agenesis should be differentiated from a lobar atrophy of right hepatic lobe caused by cirrhosis, choangiocarcinoma, idiopathic portal hypertension and anomalies of other biliary tracts. 9,18,19 Agenesis of right hepatic lobe is a rare congenital anomaly.…”

“…The diverticulum grows within the septum transversum. 1,11,16 It has been known that this anomaly is caused by the developmental failure of right portal vein or an error of mutual induction between the primitive diaphragm and the endodermal diverticulum representing the primitive liver.…”

“…9,10 Generally it is accompanied by other anomalies of biliary tree such as ectopic gall bladder, retro or suprahepatic gall bladder. [7][8][9]11,12 and compensatory hypertrophy of left hepatic lobe. 11,13,14 Agenesis of right lobe of liver is an incidental finding revealed by ultrasonography, computed tomography or magnetic resonance because the condition is asymptomatic.…”

“…[7][8][9]11,12 and compensatory hypertrophy of left hepatic lobe. 11,13,14 Agenesis of right lobe of liver is an incidental finding revealed by ultrasonography, computed tomography or magnetic resonance because the condition is asymptomatic. 15,16 Here we report a case of agenesis of right lobe of liver, discovered as an incidental finding during the diagnostic imaging studies for cirrhotic liver disease and s/o portal hypertension.…”