A 45-year-old Diabetic female with history of Laparotomy through a paramedian incision for ruptured ectopic pregnancy (20 years back), presented with cholelithiasis. She was posted for lap cholecystectomy, after placing the umbilical port and initial visualisation, the entire upper abdomen was found to be fully walled of due to dense adhesions (liver was not visible).
After conversion to an open case through standard 10 cm Rt Hypochondrial incision, the liver was found to be enclosed in dense adhesions, after adhesionolysis, it was found that most of the stomach is lateralized to the right with no sight of the gallbladder on inferior surface of apparent right hepatic lobe. On defining further, I found that the right lobe is actually pushed to far right and lateral position than usual and the left lobe instead was occupying most of the right hypochondrium( due to dense parietal…
