Abstract
A 73-year-old woman was brought into our hospital by ambulance because she had a traffic accident between automobiles. When she arrived, she complained of severe right flank pain. An abdominal CT scan showed a cord like structure connecting to the small bowel from the liver, as well as small bowel obstruction and dilatation of the proximal intestine caused by the cord. She was diagnosed with the intestinal obstruction caused by the cord like structure and we performed a single incision laparoscopic surgery to relieve the obstruction. We confirmed that the inferior margin of the right lobe of liver extended in a shape of a tongue so as to connect to the small bowel, at where intestinal obstruction was present. The tongue-like extended liver was clipped and transected by using the ultrasonic coagulation incision-apparatus to relieve intestinal obstruction. Pathological findings revealed the cord like structure contained liver pareneymal cells and bile duct structures. Accessory liver lobe (Riedel's lobe) was diagnosed. Her postoperative course was uneventful and she was discharged from our hospital on the 7th postoperative day.
Accessory liver lobe is an abnormal morphology and is often detected incidentally. Among accessory liver lobes, one arising from the right lobe of the liver and extending downward in a tongue-like shape is called Riedel's lobe. This paper deals with our experience with a case of intestinal obstruction caused by Riedel's lobe treated by laparoscopic surgery.
