Learning objectives
- Toreport two cases of Wandering Liver diagnosed by abdominal ultrasonography and cine-MRI sequences.
- To insist on the usefulness of dynamic maneuvers when confronted to atypical symptoms and a normal abdominal US scan.
Background
Wandering liver is an exceptional and rare entity in which the liver is freely mobile and displaces in the transverse plane because of hyperlaxity and elongation of the hepatic fixation complex.
It could be acquired or congenital in which there is absence of the hepatic suspensory apparatus.
A lot of synonyms are used including floating liver,
hepatoptosis,
hepatic ectopia and hepar ambulens.
All are terms referring to a situation of hyper mobility of the liver.
Its clinical presentation is variable and non specific.
Therefore,
the...
Imaging findings OR Procedure details
CASE 1
A 6-year-old autistic boy,
who suffered from cerebral palsy and underwent a Percutaneous Endoscopic Gastrostomy (PEG) tube for feeding since long time,
was complaining of recurrent chronic vomiting.
Abdominal X-ray was obtained (Fig 1),
presenting hyper lucent right upper quadrant by the presence of bowel air while the hepatic shadow was seen in the midline.
Followed real time abdominal Ultrasonography (Fig 2) confirmed the mobility of the liver which was moving in a transverse axis to the midline in left lateral decubitus position...
Conclusion
"Wandering liver" describes an excessive mobility of the liver due to abnormalities of hepatic fixation that could lead to hepatic pedicle torsion or bowel obstruction.
It is considered as a rare entity,
but thanks to the evolution in medical imaging techniques,
this unusual condition is being more often identified.
We report two cases presenting with chronic vague abdominal pain,
diagnosed by abdominal ultrasonography and the use of cine-MRI sequences with dynamic maneuvers.
We tried to correlate our US and MRI findings to per-operative findings and...
Personal Information
S.
BAUONES,
pediatric radiology department,
La Timone Hospital,
Marseille - France
E-mail:
[email protected]
G.
GORINCOUR,
pediatric radiology department,
La Timone Hospital,
Marseille - France
E-mail:
[email protected]
References
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Nichols,
Maria S.
Figarola,
& Todd B.
Standley,
A Wandering Liver.
PediatrRadiol 2010; 40:1443–1445
2- Al-Ali F,
MacphersonRI,
Othersen HB,
Chavin K (1997) A “wandering liver” in an infant.
PediatrRadiol 1997; 27:287
3- Howenstein M,
Yaghmai V,
Grant T,
Wandering liver: multidetector CT features and the importance of multiplanar reformations.
EmergRadiol 2009; 16:155–157
4- Fuentes R,
Santana JM,
Alemán JC et al,
Hepatocolonic vagrancy: a rare or under recognized entity.
AJR 2007; 188:331–333
5- Puthenpurayil K,
Blachar A,
Ferris JV,
Pelvic ectopia...