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EnglishA 3-year-old girl was admitted to the Emergency Department for the onset of severe abdominal pain a week after acute gastroenteritis. Abdominal X-ray and ultrasound showed a left-sided liver without signs of invagination or obstruction. A new abdominal ultrasound, repeated after 24 h due to the persistence of the abdominal pain, identified the liver on the right side. Abdominal CT showed that the liver was on the right side when the patient was supine and, on the left side when she was in left lateral decubitus. The condition was diagnosed as ‘Wandering Liver’ (WL).Abdominal pains spontaneously regressed within 48 h. On physical examination joint hyperlaxity and ogival palate were observed. Considering the spontaneous regression of symptoms, a “wait and see” approach was decided. After one year follow-up, the child is in good clinical condition and completely asymptomatic. WL is a rare condition characterized by excessive mobility of the liver due to the lack of normal hepatic fixation. Clinical presentation is variable from incidental finding to recurrent abdominal pain which may be severe suggesting a colonic obstruction. WL may be associated with a redundant colon that can be interposed between liver and diaphragm leading to bowel obstruction. Serial abdominal xrays and ultrasounds show the different position of the liver that may be confirmed by dynamic computed tomography and MRI. While a “wait and see” approach with a close follow-up is suggested for asymptomatic patients, surgery is necessary in case of bowel obstruction.
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| Titolo: | When the liver wanders..... | |
| Autori: | ||
| Data di pubblicazione: | 2017 | |
| Rivista: | ||
| Abstract: | A 3-year-old girl was admitted to the Emergency Department for the onset of severe abdominal pain a week after acute gastroenteritis. Abdominal X-ray and ultrasound showed a left-sided liver without signs of invagination or obstruction. A new abdominal ultrasound, repeated after 24 h due to the persistence of the abdominal pain, identified the liver on the right side. Abdominal CT showed that the liver was on the right side when the patient was supine and, on the left side when she was in left lateral decubitus. The condition was diagnosed as ‘Wandering Liver’ (WL).Abdominal pains spontaneously regressed within 48 h. On physical examination joint hyperlaxity and ogival palate were observed. Considering the spontaneous regression of symptoms, a “wait and see” approach was decided. After one year follow-up, the child is in good clinical condition and completely asymptomatic. WL is a rare condition characterized by excessive mobility of the liver due to the lack of normal hepatic fixation. Clinical presentation is variable from incidental finding to recurrent abdominal pain which may be severe suggesting a colonic obstruction. WL may be associated with a redundant colon that can be interposed between liver and diaphragm leading to bowel obstruction. Serial abdominal xrays and ultrasounds show the different position of the liver that may be confirmed by dynamic computed tomography and MRI. While a “wait and see” approach with a close follow-up is suggested for asymptomatic patients, surgery is necessary in case of bowel obstruction. | |
| Handle: | http://hdl.handle.net/11392/2377361 | |
| Appare nelle tipologie: | 03.5 Abstract su rivista |
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