Anteriorly Rotated Liver Anomaly in a Prosection Cadaver

Abstract

The abdominal contents of a 85 year old male cadaver whose cause of death was decompensated congestive heart failure presented with an anteriorly rotated liver that had an enlarged right lobe and much reduced left lobe. The caudate lobe was also much reduced. The gall bladder was oriented vertically, facing the anterior abdominal wall. Other visceral abnormalities included the stomach, which was horizontal in orientation, with the greater curvature facing the anterior abdominal wall and greater omentum shifted to the left. The ascending colon continued beyond the hepatic flexure, and the transverse colon was located in the left upper quadrant. The descending colon was shifted towards the right and the sigmoid colon was enlarged, and it and the sigmoid mesocolon were located in the right lower quadrant. The vasculature of the viscera originated from the unpaired abdominal aortic branches in typical fashion, except that some were of different lengths to reach the organs that they supplied. One such vessel was the proper hepatic artery as it had to traverse the abdominal cavity further horizontally than typical due to the displacement of the liver. The inferior mesenteric artery took a looping path to the right lower quadrant due to the displacement of the sigmoid colon. The middle colic artery branch of the superior mesenteric traveled vertically and to the left to supply the transverse colon located in the left upper quadrant.Literature provides few examples of this anomaly. An autopsy of a 39 year old African American female had similar presentation of the liver and gall bladder but no report of unusual presentation of the colon.(https://www.hindawi.com/journals/crihep/2013/493713/(2013)) It was also reported as a result of a CT scan of an 82 year old Indian male that was performed due to left flank pain (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159280/(2017)). Noted during exploratory surgery of a 30‐year‐old African American male with a pleuroperitoneal hiatus that also had congenital deformities of the right upper extremity and a club foot, the liver was rotated into the left upper quadrant with a posteriorly placed gall bladder (Diseases of the Chest 29: 583‐4(1956)).