Abstract
Ectopic liver tissue is a rare clinical entity that is mostly asymptomatic and found incidentally. In certain situations, however, patients may present with symptoms of abdominal pain secondary to torsion, compression, obstruction of adjacent organs, or rupture secondary to malignant transformation. Herein, we report a case of a 25-year-old female that presented with acute onset of epigastric pain found to have ectopic liver tissue near the gallbladder complicated by acute hemorrhage necessitating operative intervention in the way of laparoscopic excision and cholecystectomy. The patient's postoperative course was uneventful. Gross pathology demonstrated a 1.2 × 2.8 × 4.5 cm firm purple ovoid structure that histologically revealed extensive hemorrhagic necrosis of benign ectopic liver tissue.
Highlights
Ectopic liver tissue is a rare entity that involves the presence of hepatic tissue in a number of sites outside of the native liver such as the gallbladder, hepatic ligaments, omentum, retroperitoneum, and thorax [1,2,3,4,5]
We report a case of ectopic liver tissue complicated by acute hemorrhage without any evidence of underlying malignancy
Though there have been reports of ruptured ectopic liver tissue in the setting of malignant degeneration into hepatocellular carcinoma (HCC), this is the first case to our knowledge where benign hepatic tissue presented with symptomatic spontaneous hemorrhage [7]
Summary
Ectopic liver tissue is a rare entity that involves the presence of hepatic tissue in a number of sites outside of the native liver such as the gallbladder, hepatic ligaments, omentum, retroperitoneum, and thorax [1,2,3,4,5] In most situations, they are asymptomatic and found incidentally. Workup in the way of liver function tests and abdominal ultrasound did not demonstrate evidence suggesting biliary or gallbladder pathology, and as such she was discharged home. She represented within hours of discharge due to worsening symptoms. The differential diagnosis included a ruptured hepatic adenoma, biliary cystic lesion, or enteric cyst Secondary to these findings and her persistent symptoms the patient was taken to the operating room. Age 71 y.o. female 54 y.o. male 39 y.o. female 56 y.o. male 64 y.o female 37 y.o. male 59 y.o. male
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