Hypoplasia of the left lobe of the liver

The Role of Pathological Examination of the Liver in Medicolegal Autopsy: A Tertiary Care Center Study From North India

BACKGROUND

The pathological examination of a medicolegal autopsy is a great learning opportunity for a pathologist as well as for a forensic expert, where the cause of death remains unknown. Liver disease epidemiology differs from one geographic area to another.

MATERIAL AND METHODS

This was a prospective observational study with 100 medicolegal autopsy cases over a one-year period conducted in the Department of Forensic Medicine and Toxicology (FMT) and Pathology. Representative tissue from the liver was collected in 10% neutral buffered formalin and sent for histopathological examination.

RESULTS

The mean age of the cases was 41.98 ± 15.39 years, and ages ranged from 20 to 90 years with male preponderance. The most common histopathology and gross findings noted were mild to moderate chronic hepatitis (CH) (54%) and fatty change (36%), respectively. There was a significant association (p ≤ 0.05) between histopathology and gross findings, cause, and manner of death.

CONCLUSION

Gross and histopathological examination of the liver in a medicolegal autopsy has a significant role in ascertaining the cause and manner of death.

Robot-Assisted Liver Resection and Cholecystectomy Using Indocyanine-Green for Intrahepatic Cholangiocarcinoma, in a Very Rare Anatomical Anomaly of ‘Bipartite Liver’

Robotic hepatobiliary surgery has significantly developed worldwide with substantial clinical results. Hepatobiliary anatomical anomalies increase the complexity of hepatobiliary resection with a relevant risk of iatrogenic lesions. Among congenital liver anomalies, the ‘bipartite liver’ is an extremely rare condition which might be associated with complex surgical dissection of the hepatic hilum. We herein report a rare case of congenital ‘bipartite liver’ associated with a cholangiocarcinoma of segment VI and calculous cholecystitis. The patient underwent robot-assisted segmentectomy and cholecystectomy with the use of indocyanine-green cholangiography and intraoperative ultrasound. A challenging hilar dissection was performed using this approach. To the best of our knowledge, this is the first case reported that describes a robot-assisted liver resection and cholecystectomy in a patient having a cholangiocarcinoma associated with this rare liver anomaly. The robotic approach was safe and effective and the 3D preoperative imaging, as well as the intraoperative green-indocyanine cholangiography was extremely useful, especially during hilar dissection and cholecystectomy.

Agenesis of hepatic lobes in a dog

Agenesis of a hepatic lobe is an extremely rare congenital anomaly and only one dog have been reported in veterinary literature. We encountered a dog with this anomaly diagnosed by Computed tomography (CT) and portography. A two-year-old, 6.9-kg female Shih tzu dog was presented with vomiting and anorexia. The dog had no history of abdominal surgery or trauma. Biochemical analysis showed elevated plasmatic liver enzymes. CT revealed the absence of the liver parenchyma and vascular system of the left lobe, quadrate lobe and papillary process of the caudate lobe. A portosystemic shunt was also observed. The liver parenchyma and vascular system of these lobes were not detected under digital subtraction angiography during laparotomy. Furthermore, the liver parenchyma and vascular system of these lobes were not detected even when the remaining liver volume increased two months after treating the shunt vessel. CT proved itself a good option for antemortally diagnosis of hepatic agenesis in a dog.

MRI rare finding: Absence of the left liver lobe

We report a rare case of left liver lobe absence in an 80-year-old male patient discovered during an MRI scan. The main imaging features of this condition are briefly reviewed, together with its pathogenesis and the most common associations and differential diagnoses.

Gastric volvulus associated with agenesis of the left lobe of the liver in a child: a case treated by laparoscopic gastropexy

Association of gastric volvulus with agenesis of the left lobe of the liver is very rare and mostly reported in adults. We report a case of gastric volvulus associated with agenesis of the left lobe of the liver in a child, which was successfully treated by laparoscopic gastropexy.

Bifid liver presenting with anomalous quadrate and caudate lobes and a transverse gallbladder

The current Observation reports multiple anomalies of the liver of a 55-year-old male cadaver. Observations revealed the presence of anomalies on the diaphragmatic and visceral surfaces of the liver. The diaphragmatic surface presented with a deep furrow that run obliquely from the fissure for the inferior vena cava to the inferior border of the liver. It divided the liver partially into the right and left segments that remained united by the liver tissue that measured about 0.7 cm thick. The two segments were easily pulled apart for up to 3 cm. A similar fissure did not appear on the visceral surface. The visceral surface presented with multiple anomalies that included a vertically oriented porta hepatis, abnormal Y-shaped fissures on the right lobe, transverse gallbladder, absence of the caudate process on the caudate lobe, abnormal quadrate lobe, and transverse fissure on the right lobe. The three fissures that formed a Y-shaped configuration delineated the quadrate lobe. The right and left arms of the Y-shaped fissure terminated in the porta hepatis. Congenital anomalies of the adult liver are rare; therefore continued documentation of such anomalies remains to be important in medical sciences and in the understanding of liver ontogeny.

Left lobe hypoplasia of the human liver: a report of two cases

Two cases of left lobe hypoplasia of the human liver were dissected minutely to show the intrahepatic vessels and ducts. In the left side of the round ligament, one case had a large cyst-like mass containing dilated vessels and ducts, while the other was accompanied by three rugby-ball-like parenchymal masses, each of which was covered by the peritoneum. The former specimen carried the usual Spiegel's lobe, while the latter was very small. Fascial and peritoneal fusion was evident at and around these two left lobes. In both cases the left hepatic vein showed the usual course and terminal end, segment IV was present to a greater or lesser degree. Thus, we hypothesized that, due to fascial and peritoneal fusion, membranous stricture occurred at the peripheral portions of the left portal trunk and left hepatic duct. The discussion focuses on a comparison of intrahepatic vascular configurations in four recently reported cases, including the present two livers.