Zusammenfassung
Akzessorische Leberlappen (accessory lobes of the liver, ALL) können angeboren oder
erworben sein, und haben in der Regel keine klinische Bedeutung. Leberlappentorsion
(ALL torsion) ist äußerst selten, und die meisten Torsionen werden zufällig während
einer Laparotomie, einer Autopsie, oder während radiologischer Untersuchungen entdeckt.
Insgesamt wurden bisher bei Kindern und Erwachsenen nur 17 Fälle in der medizinischen
Literatur beschrieben. Alle Fälle, die seit 1925 beschrieben wurden, wurden während
einer Laparotomie diagnostiziert. Wir berichten hier über den 18. Fall von Leberlappentorsion,
der bei einer älteren Frau diagnostiziert wurde. Trotz mehrerer radiologischer Interventionen
konnte die Leberlappentorsion erst durch eine Laparotomie diagnostiziert werden. Wir
ziehen daraus die Schlussfolgerung, dass Leberlappentorsion ein seltener Befund ist,
und dass radiologische Untersuchungen nicht zu einer Diagnose führen. Dahingegen werden
die meisten Fälle von Leberlappentorsion während einer Laparotomie entdeckt. Laparoskopie
kann zur Diagnose von Leberlappentorsion hilfreich sein. Bei anhaltendem Schmerz empfehlen
wir einen chirurgischen Eingriff, mit oder ohne Cholezystektomie.
Abstract
Accessory lobes of the liver (ALL) may be congenital or acquired and are usually of
no clinical significance. Torsions of the ALL are exceedingly rare and most are incidental
findings at laparotomy, autopsy and in the course of investigation radiological investigations.
A total of 17 infant and adult cases have been described previously in the medical
literature. Most cases described since 1925 have been diagnosed at laparotomy, we
report the 18th case of torsion of the accessory lobe of the liver in an elderly female which, despite
all radiological interventions, required laparoscopy for diagnosis. We conclude that
torsion of the accessory lobes of the liver is a rare finding; radiological imaging
does not reveal the diagnosis and most are found at laparotomy. Laparoscopy may aid
in the diagnosis of torsion of accessory liver lobes. If pain persists, we advocate
the use surgical intervention with or without cholecystectomy.
Schlüsselwörter
akzessorische Leberlappen - radiologische Diagnostik - Laparotomie - Laparoskopie
Key words
Accessory - liver lobes - radiological imaging - laparotomy - laparoscopy
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