Tongue-like elongation of the left lobe of liver

Introduction The liver is the largest gland in our body. Liver normally has a larger right lobe and a smaller left lobe. Though the tongue-like projection of the right lobe of the liver, i.e., Riedel’s lobe, is commonly found in literature, the left lobe has very few literature. In foetal life, the left lobe is nearly as large as its right and as the haematopoietic activity of the liver is assumed by the spleen and bone marrow, the left lobe undergoes some degeneration. This paper discusses the tongue-like elongation of the left lobe of the liver. Case series Three livers with tongue-like elongation of the left lobe were found during routine dissections of 20 cadavers in the Department of Anatomy, Gauhati Medical College, Guwahati. On examination, the colour, consistency, and texture of the elongated parts were found to be similar to normal livers and histological examination showed normal liver tissue. There was absence of fibrous tissue, so the elongated parts were not the appendix of the liver. Other parts of the liver were normal. Conclusion This type of elongation of the left lobe of the liver may cause symptoms like pressure, pulling and pain in the epigastrium. Moreover, knowledge of this type of liver anomalies will be helpful for surgeons in planning hepato-biliary surgeries. Introduction The liver is one of the most precocious embryonic organs and is the centre of haemopoiesis in the foetus. It develops from an endodermal evagination of the foregut and from the septum transversum mesenchyme. The liver is proportionately large during its development. At three months of gestation, the liver almost fills the abdominal cavity and its left lobe is nearly as large as its right. When haematopoietic activity of the liver is assumed by the spleen and bone marrow, the left lobe undergoes some degeneration and becomes smaller than the right1. According to Barclay-Smith, “The changes which the liver undergoes during growth require elucidation. The small size of the left lobe in the adult as compared with an early condition may be either due to its relatively slow growth or to an actual atrophy of liver substance”2. Anomalies of hepatic morphology, as opposed to anatomical variations, are rare. Nevertheless, knowledge of such anomalies is important since they do not always remain clinically latent. A general review of hepatic anomalies can be divided into two categories, i.e., anomalies due to defective development and anomalies due to excessive development of the liver3. Riedel’s lobe was first recognised as an anatomical variant of the liver4, consisting of an inferior extension of the right lobe of the liver. Variants of anatomy of the left lobe of the liver are less recognised. Congenital deformities of the liver confined to the left lobe are sufficiently extensive to cause symptoms5. Bismuth-Couinaud segment II is commonly elongated. In segmental * Corresponding author Email: [email protected] Department of Anatomy, Fakhruddin Ali Ahmed Medical College, Barpeta, Assam, India Figure 1: Abnormal liver no.1 with elongated left lobe.