HYPOPLASTIC RIGHT HEPATIC LOBE WITH RETROHEPATIC GALLBLADDER COMPLICATED BY HEPATOLITHIASIS AND LIVER-ABSCESS - A CASE-REPORT

A 37-year-old man with fever, jaundice, severe right upper quadrant ab dominal pain and impending septic shock was pre-operativly diagnosed t o have hypoplastic right lobe liver with retrohepatic gallbladder, lef t hepatolithiasis and liver abscess by computed tomography. An urgent operation with cholecystectomy, choledocholithotomy, operative choledo choscopy and T-tube drainage was performed. Postoperative cholangiogra ms depicted multiple residual stones behind the sharply angualted bili ary strictures in the medial branches of the left intrahepatic duct, w hich could not be eradicated by biliary dilatation. via the T-tube tra ct. The left hepatolithiasis might be coincidental, or secondary to th e congenital anomaly of the liver, because of the distorted biliary ar chitecture, and the hypoplastic right lobe liver was associated not on ly with the retrohepatic gallbladder, but also with the much more comp licated left biliary strictures and the hepatolithiasis behind them.