Accessory Hepatic Lobe Strangulated in Post-traumatic Diaphragmatic Hernia

Main Article Content

Issam Hamrerras
Abdelillah El. Bakouri
Sylvestre Kabura
Fatimazahra Bensardi
Khalid El. Hattabi
Abdelaziz Fadil

Abstract

The accessory lobe of the liver is a rare morphological variation. It is frequently found in the lower segments. Riedel's lobe is the best known of the accessory lobes of the liver and corresponds to an enlargement of segments V and VI with an incidence of 3.3% to 14.5%. It is often diagnosed incidentally and sometimes revealed by a complication, the association of a strangulated post-traumatic diaphragmatic hernia containing the Riedel's lobe is an unusual situation. The present study report the first case of this association in a patient, admitted in emergency after a violent closed thoraco-abdominal trauma following a public road accident four days earlier. The physical examination was poor and the symptoms were non-specific. The diagnosis was made by preoperative imaging, the chest X-ray found the digestive gas into the thoracic cavity, the thorax and abdominal CT scan showed a solution of continuity of the right anteromedial part of the diaphragm through which protrudes in the intrathoracic the segment of the liver with parenchyma perfusion disorders and a dilated colonic segment in the right hemi thoracic cavity without signs of pneumatosis. There was a repression of the mediastinum organs to the left thoracic cavity. The surgical treatment consisted in a reduction of the hernia content, which was viable with the diaphragmatic defect closure with non absorbable interrupted suture. The post operative was uneventfull. The aim of this study is to show the possibility of this association which must be kept in mind in case of violent closed thoraco-abdominal trauma or basithoracic injury.

Keywords:
Accessory lobe of the liver, diaphragmatic hernia, Strangulated Riedel's lobe.

Article Details

How to Cite
Hamrerras, I., Bakouri, A. E., Kabura, S., Bensardi, F., Hattabi, K. E., & Fadil, A. (2020). Accessory Hepatic Lobe Strangulated in Post-traumatic Diaphragmatic Hernia. Asian Journal of Research and Reports in Hepatology, 2(1), 1-5. Retrieved from http://journalajrrhe.com/index.php/AJRRHE/article/view/30094
Section
Case Report

References

Kurniawan J, Anggraeni DN, Dewiasty E, Lutfie L. Riedel’s Lobe: Clinical importance of a rare variant in liver morphology. Acta Medica Indones. 2017;49(1):57‑62.

Kafih M, Boufettal R. Hernie diaphragmatique post-traumatique révélée par une pleurésie stercorale (A propos d’un cas). Rev Pneumol Clin. 2009;65 (1):23‑6.

Glenisson M, Salloum C, Lim C, Lacaze L, Malek A, Henriquez A, et al. Les lobes accessoires du foie: Anatomie et implications cliniques. J Chir Viscérale. 2014;151(6):466‑70.

Chaudhari HJ, Ravat MK, Vaniya VH, Bhedi AN. Morphological study of human liver and its surgical importance. J Clin Diagn Res JCDR. 2017;11(6):AC09-AC12.

Pryakhin A, Yukhimets S, Chernomortseva E, Gesase AP. Accessory Lobes, Accessory Fissures and Prominent Papillary Process of the Liver. 2015; 4:6.

Singh HR, Rabi S. Study of morphological variations of liver in human. Transl Res Anat. 2019;14:1‑5.

Sandstrom CK, Stern EJ. Diaphragmatic hernias: A spectrum of radiographic appearances. Curr Probl Diagn Radiol. 2011;40(3):95‑115.

Eren S, Çiriş F. Diaphragmatic hernia: Diagnostic approaches with review of the literature. Eur J Radiol. 2005;54(3):448‑59.

Thakral CL, Shivalingam G, Dar FM, Thakral N. Torsion of an accessory hepatic lobe with Embedded Gallbladder: In an 11-Month-Old Boy. Eur J Pediatr Surg Rep. 2017;5(1):e62‑4.

Park Ariel H, Tran Tien-Anh, et Neychev, Vladimir. Accessory liver lobe attached to the wall of the gallbladder. Cureus. 2019; 11(11).

Eljai RS, Boufettal R, Farah RH, Chehab F. Kyste hydatique pancréatique: A propos d’un cas. Pan African Medical Journal. 2015;21(1).