Nadir görülen ilginç bir ektopik karaciğer olgusu

Year 2022, Volume: 15 Issue: 2, 393 - 397, 31.08.2022

Recep Çağlar

https://doi.org/10.26559/mersinsbd.1066126

Abstract

Ektopik karaciğer; hepatik koristoma veya hepar succenturiatum olarak da bilinen ana karaciğere bağlı olmayan karaciğer dokusudur. Genellikle otopsi ve ameliyat esnasında tesadüfen saptanan nadir bir gelişimsel anomalidir. İnsidansının %0.24 ile %0.47 arasında değiştiği bildirilmiştir. En sık safra kesesinde görülmekle birlikte daha az oranda diğer organlarda da görülebilir. Karın ağrısı şikayeti ile polikliniğimize başvuran 38 yaşında kadın hastanın yapılan ultrasonografisinde multıpl kolelitiazis tespit edildi. Elektif laparoskopik kolesistektomi esnasında safra kesesi üzerinde tesadüfen saptanan ve nadir görülen ilginç bir ektopik karaciğer olgusunu sunuyoruz. Safra kesesi içerisinde ve üzerinde yer işgal eden kitlelerin ayırıcı tanısında ektopik karaciğer dokusu akılda tutulması gereken bir anomalidir. Genellikle klinik olarak sessizdir ve tesadüfen bulunur. Eğer safra kesesinde patoloji varsa safra kesesi ile beraber rezeksiyonu, safra kesesi dışında ise artmış hepatoselüler malignite riski nedeniyle cerrahi tedavi önerilmektedir. 

Keywords

Ektopik karaciğer, Hepatik koristoma, Heterotropik karaciğer, Safra kesesi

Supporting Institution

yoktur

An interestıng rare case of ectopic liver

Abstract

Ectopic liver is a liver tissue that is not connected to the main liver, also known as a hepatic choristoma or hepar succenturiatum. It’s a rare developmental anomaly that is usually detected incidentally during autopsy and surgery. It’s incidence has been reported to range from 0.24%-0.47%. It’s most commonly seen in the gallbladder, but less frequently in other organs. Multiple cholelithiasis was detected in the ultrasonography of a 38-year-old female patient who applied to our outpatient clinic with the complaint of abdominal pain. We presented an interesting and rare case of ectopic liver incidentally detected on the gallbladder during elective laparoscopic cholecystectomy. Ectopic liver tissue is an abnormality that should be kept in mind in the differential diagnosis of masses occupying space in the gallbladder. It’s usually clinically silent and found by chance. If there is pathology in the gallbladder, surgical treatment is recommended due to the risk of resection with the gallbladder and increased risk of hepatocellular malignancy if it’s outside the gallbladder. 

Keywords

Ectopic liver, gallbladder, hepatic choristoma, heterotropic liver

References

• Kachi A, Bou Rached C, El-Helou E, Kanj M, Kansoun AH. Incidental finding of ectopic liver during laparoscopic cholecystectomy. Am J Case Rep. 2020; 3(21): e921410.
• Karaca G, Özden H, Pehlivanlı F, Pekcici MR, Yıldırım Y. Ectopic liver tissue on the gallbladder: An incidental mass in laparoscopy. Arch Iran Med. 2016; 19(1): 78-79.
• Martinez CA, de Resende HC Jr, Rodrigues MR, Sato DT, Brunialti CV, Palma RT. Gallbladder associated ectopic liver: A rare finding during a laparoscopic cholecystectomy. Int J Surg Case Rep. 2013; 4(3): 312-315. doi: 10.1016/j.ijscr.2013.01.006
• Vaideeswar P, Yewatkar D, Nanavati R, Bhuiyan P. Ectopic liver tissue in umbilical cord. J Postgrad Med. 2011; 57(3): 229-230.
• Watanabe M, Matsura T, Takatori Y, et al. Five cases of ectopic liver and a case of accessory lobe of the liver. Endoscopy. 1989; 21(1): 39-42.
• Sato S, Watanabe M, Nagasawa S, Niigaki M, S12akai S, Akagi S. Laparoscopic observations of congenital anomalies of the liver. Gastrointest Endosc. 1998; 47(2): 136-140.
• Akbulut S, Demyati K, Ciftci F ve ark. Ectopic liver tissue (choristoma) on the gallbladder: A comprehensive literature review. World J Gastrointest Surg. 2020; 12(12): 534-548.
• Thorsness ET. The relationship of True Luschke Ducts, adenoma and aberrant liver tissue in the wall of the human gallbladder. Am J Clin Pathol. 1941; 11(12): 878-881.
• Lundy J, Johnson E, Edwards K, Rivera D. Laparoscopic management of gallbladder-associated ectopic liver. JSLS. 2005; 9(4): 485-487.
• Koh CE, Hunt R. Encountered during laparoscopic cholecystectomy. Asian Surg. 2007; 30(3): 227-230.
• Hamdani SD, Baron RL. Ectopic liver simulating a mass in the gallbladder wall: Imaging findings. ARJ. 1994;162(3):647-648.