Partial hepatic volvulus and acute biliary obstruction

Partial hepatic volvulus, also described as wandering liver, hepatoptosis or hepatic vagrancy, is a rare condition that has been reported in adult, paediatric and neonatal populations. The variant is characterised by hepatic mobility due to laxity in the hepatic suspensory attachments. This laxity can lead to displacement of the liver into the left abdomen, resulting in clinical symptoms and complications.We report a unique presentation of partial hepatic volvulus resulting in torsion and obstruction of the bile duct. Torsion of the porta hepatis introduces a novel and clinically important aspect of the diagnosis and management of acute biliary obstruction.The patient was initially managed with attempted biliary endoscopic decompression, which failed, and ultimately underwent surgical intervention with restoration of conventional hepatic positioning through plication and hepatopexy of the suspensory ligaments of the liver. This case highlights the patient’s presentation, diagnosis and operative management of hepatic volvulus and acute biliary obstruction.