A peculiar liver with surgically and radiologically important variations: a case report

Abstract

A peculiar liver was found in an adult male cadaver during a dissection class for undergraduate medical students. The quadrate lobe and fissure for the ligamentum teres were totally absent. Thus, the cystic notch on the inferior border was very broad and deep, and the fundus and body of the gall bladder popped out through this notch. The cystic duct terminated into the right hepatic duct at the porta hepatis instead of terminating into the common hepatic duct. Awareness of variations of the lobes and fissures may minimize a misdiagnosis of liver problems. The aim of the current study was to alert radiologists and surgeons about possible variations in the external appearance and anomalies of the lobes and fissures of the liver.

Clinically Oriented Classification of Anatomic Variants of the Umbilical Fissure for Ligamentum Teres in the Human Liver

“…There have been reports describing variations of the UF [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], but a robust classification system was not encountered. We proposed a morphologic classification based on the variations encountered.…”

“…In the published literature, similar variations have been described using different names. This variant has been described as a "liver not divided into lobes on the visceral surface" by Kale et al [7], as "tissue of pons hepatis leaving no boundaries for quadrate lobe" by Anbumani et al [22], as a "complete absence of a quadrate lobe" by Ebby and Ambike [10] and Joshi et al [6], and as "absence of a left lobe" by Abdullahi et al [9], Satessha et al [12] and Aktan et al [4]. This variant was present in 1.5% of individuals in our series.…”

“…Type IV variants were the most common morphologic variants in our population. These variations have been reported with various names applied to them, such as pons hepatis [ 5 - 6 , 14 , 16 , 18 , 21 - 22 ], absent fissure for ligamentum teres [ 9 , 12 , 17 ] and ligamentum teres tunnel [ 10 - 11 , 15 , 19 ]. We propose the use of standardized nomenclature and classifications, possibly those proposed within this paper.…”

Omento-cystic peritoneal fold and rudimentary quadrate lobe: A case report

“…It is extremely rare to have a total absence of any lobe of the liver. Recently, a case of total absence of quadrate lobe has been reported 12 .…”