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一例因肠扩张导致的游走折叠肝:附文献复习的新病例报告

A wandering folded liver displaced by the distended bowel: a new case report with review of the literature.

作者信息

Rabie Mohamed A, Godavitarne Charles

机构信息

a Queen Elizabeth the Queen Mother Hospital , Margate , UK.

b Ain Shams University Hospital , Cairo , Egypt.

出版信息

Acta Chir Belg. 2017 Oct;117(5):319-323. doi: 10.1080/00015458.2016.1272252. Epub 2017 Jan 3.

Abstract

INTRODUCTION

The wandering liver is an extremely rare condition in which the liver moves significantly or 'wander' with changes in patient's lie. This is believed to be an acquired condition perhaps precipitated by persistent congenital ventral mesogastrium which acts as an axis or a mesentery for the liver to rotate. The vast majority of reported cases were associated with other chronic abnormalities of the gastrointestinal tract, especially sigmoid volvulus.

PATIENTS AND METHODS

We present a case report of an acquired isolated transposition of the liver with a review of the English-language literature of wandering liver in adults and paediatric age group.

RESULTS AND CONCLUSIONS

The clinical presentation of wandering liver is variable. Most of the reported cases were asymptomatic and are usually diagnosed while having investigation or surgery for other reasons, especially the commonly associated bowel problems. However, some patients may present with intermittent jaundice and abdominal pain secondary to the abnormal liver configuration. Due to the scarcity of the condition, the diagnosis can be challenging and improper concerns of permanent liver failure is possible. Hepatopexy is usually required for symptomatic patients with good results.

摘要

引言

游走肝是一种极为罕见的病症,肝脏会随着患者体位的改变而发生显著移动或“游走”。据信这是一种后天性病症,可能由持续存在的先天性腹侧胃系膜引发,该系膜充当肝脏旋转的轴或系膜。绝大多数已报道的病例与胃肠道的其他慢性异常有关,尤其是乙状结肠扭转。

患者与方法

我们报告一例后天性孤立性肝脏转位病例,并对成人和儿童年龄组游走肝的英文文献进行综述。

结果与结论

游走肝的临床表现多样。大多数已报道病例无症状,通常是在因其他原因进行检查或手术时被诊断出来,尤其是常见的相关肠道问题。然而,一些患者可能会因肝脏形态异常而出现间歇性黄疸和腹痛。由于这种病症较为罕见,诊断可能具有挑战性,并且可能会不恰当地担心永久性肝功能衰竭。对于有症状的患者,通常需要进行肝脏固定术,效果良好。

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