Torsion and infarction of an accessory liver lobe

Accessory lobes of the liver (ALL) may be congenital or acquired and are usually of no clinical significance. Torsions of the ALL are exceedingly rare and most are incidental findings at laparotomy, autopsy and in the course of investigation radiological investigations. A total of 17 infant and adult cases have been described previously in the medical literature. Most cases described since 1925 have been diagnosed at laparotomy, we report the 18th case of torsion of the accessory lobe of the liver in an elderly female which, despite all radiological interventions, required laparoscopy for diagnosis. We conclude that torsion of the accessory lobes of the liver is a rare finding; radiological imaging does not reveal the diagnosis and most are found at laparotomy. Laparoscopy may aid in the diagnosis of torsion of accessory liver lobes. If pain persists, we advocate the use surgical intervention with or without cholecystectomy.