title: Gallbladder-associated ectopic liver: A rare finding during a laparoscopic cholecystectomy.
abstract: BACKGROUND
  Ectopic hepatic tissue is due to an uncommon failure of embryological liver development that is rarely described in the world medical literature. The incidence of ectopic liver (EL) has been reported to be anywhere from 0.24% to 0.47% as diagnosed at laparotomy or laparoscopy. We describe a case of EL adherent to the gallbladder, removed at laparoscopic cholecystectomy.
  
  
  METHODS
  A 37-year-old female was admitted for elective cholecystectomy having had an episode of acute cholecystitis provoked by gallstones. During the procedure, a 30mm×10mm×5mm section of EL tissue attached to the anterior wall of the gallbladder was identified and removed by en-bloc excision during laparoscopic cholecystectomy. Histological examination confirmed the absence of malignant degeneration of the hepatic tissue. The patient recovered well postoperatively and was discharged the day after the operation. She was well when seen six months later.
  
  
  CONCLUSIONS
  EL has been reported in several sites, such as the gallbladder, gastrohepatic ligament, adrenal glands, esophagus, and thoracic cavity. EL is often clinically silent and discovered incidentally during abdominal surgical procedures or autopsies. Because patients with ectopic liver may suffer complications such as torsion, peritoneal bleeding, fatty change, and evolution to cirrhosis or malignant degeneration to hepatocellular carcinoma, any ectopic liver tissue needs to be correctly identified and removed.
  
  
  CONCLUSIONS
  Despite the rare occurrence of EL, it should be recognized and removed by the surgeon to prevent a higher risk of complications and malignant transformation.
authors: Department of Surgery of São Francisco Medical University Hospital, Av. São Francisco de Assis, 218, CEP: 12916-900, Bragança Paulista, São Paulo, Brazil. Electronic address: caomartinez@uol.com.br.
authors: Carlos Augusto Real
authors: CA
authors: Martinez
authors: Hermínio Cabral
authors: HC
authors: de Resende
authors: Murilo Rocha
authors: MR
authors: Rodrigues
authors: Daniela Tiemi
authors: DT
authors: Sato
authors: Cyntia Viegas
authors: CV
authors: Brunialti
authors: Rogério Tadeu
authors: RT
authors: Palma
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