Abstract
A wandering liver is a rare development in both the adult and pediatric population where the liver is freely displaced along a transverse axis. We describe the first known occurrence in published literature of a wandering liver in an adult individual who also had an intestinal malrotation complicated by a midgut volvulus. The abnormal ability for a liver to wander presents a highly unusual anatomy that can be disorienting. Laparoscopic surgery is a viable option in reducing a midgut volvulus and addressing an intestinal malrotation in the presence of a wandering liver. This unusual presentation educates clinicians to avoid potential misdiagnosis given the abnormal location of the duodenum, appendix, liver, and gallbladder.
Highlights
Wandering liver is a term used to describe a rare development, resulting from a structural malformation in the hepatic suspensory apparatus, in which the liver is free to displace along the transverse axis around the inferior vena cava
We describe the first known presentation of a wandering liver and intestinal malrotation in an adult resulting in acute midgut volvulus
A persistent ventral mesentery is known to be associated with malrotation and volvulus; because the ligaments of the hepatic suspensory apparatus are derived from the ventral mesentery before it fuses with the peritoneum, it has been proposed that a persistent ventral mesentery could represent an arrest in the normal development of these ligaments, which predisposes them to laxity, allowing the liver to “wander” [2, 3]
Summary
Wandering liver is a term used to describe a rare development, resulting from a structural malformation in the hepatic suspensory apparatus, in which the liver is free to displace along the transverse axis around the inferior vena cava Both congenital and—more commonly—acquired forms of wandering liver have been described [1]. Case presentation A 69-year-old male presented with a long-standing history of nausea, vomiting, abdominal pain, and weight loss. Prior to this presentation, he was under the care of multiple gastrointestinal physicians for diet intolerance, bloating, and intermittent abdominal pain, which was attributed to diverticulosis of the small bowel. At 2 weeks of follow-up, resolution of symptoms was demonstrated
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