Partial hepatic volvulus and acute biliary obstruction

Area of Science:

• Hepatology
• Gastroenterology
• Surgical Anatomy

Background:

• Partial hepatic volvulus (wandering liver) is a rare condition characterized by liver mobility due to lax hepatic suspensory attachments.
• This mobility can lead to liver displacement, causing various clinical symptoms and complications.

Purpose of the Study:

• To report a unique case of partial hepatic volvulus causing torsion and obstruction of the bile duct.
• To highlight the diagnostic and management challenges of acute biliary obstruction secondary to hepatic volvulus.

Main Methods:

• Case report detailing a patient with partial hepatic volvulus presenting with acute biliary obstruction.
• Initial management involved attempted endoscopic biliary decompression, followed by surgical intervention.
• Surgical approach included plication and hepatopexy of the liver's suspensory ligaments.

Main Results:

• The patient presented with acute biliary obstruction due to torsion of the porta hepatis secondary to partial hepatic volvulus.
• Endoscopic decompression was unsuccessful.
• Surgical intervention successfully restored normal liver position and resolved the obstruction.

Conclusions:

• Partial hepatic volvulus can present with acute biliary obstruction via porta hepatis torsion, a novel aspect of this condition.
• Surgical management, including ligament plication and hepatopexy, is effective in treating hepatic volvulus with biliary obstruction.