1. Dr.S.Marimuthu, M.S., D.N.B., M.Ch
Consultant Surgical Oncologist
Vishnu Cancer Centre & Research Institute
THANJAVUR, INDIA
RIEDEL’S LOBE OF
LIVER

2. Riedel's lobe of the liver
• an inferior, tongue like projection of the
anterior border of the right lobe of the liver to
the right of the gallbladder inferior to the
costal margin
• Normal anatomical variant

3. Riedel's lobe of the liver
• It was originally defined as a tongue-like
projection of the right hepatic lobe to or beyond
the level of the umbilicus
• but in recent years the definition has been
refined to a caudal extension of the liver beyond
the most inferior costal cartilage on cross-
sectional imaging. Hence, it has a variable
reported incidence of 3.3-31%

7. The etiology
• The proportion of individuals in whom the
most caudal margin of the liver was inferior to
the most caudal costal margin was age-
dependent and increased to 65% in the 50-59
age group.
• The craniocaudal dimension of the liver
decreased with age (P < 0.02).

8. The etiology
• Riedel's lobe seems to be a simple anatomical
variation
• secondary to inflammation or attachment to
other tissue rather than a congenital anomaly
• its prevalence being dependent on age-
related changes in liver size and skeletal
shape.

9. The etiology
• It has been attributed to edema from cholecystitis and
appendicitis, hepatic tumors, and constriction from
tight corsets (it is more common in women).
• More recent work has shown that its prevalence
increases with age, being seen on imaging in about
60% of people between 45 and 65 years of age, and
25% of people between 20 and 45 years of age.
• The observation that the craniocaudal extent of the
liver actually diminishes with age, while the prevalence
of Riedel's lobe increases with age has led some to
suggest that Reidel's lobe is the result of skeletal
degeneration

10. Clinical significance
• Clinically, this may be confused for a mass,
prompting imaging referral.
• So, one of causes of palpable abdominal mass.
• Recognition of this normal variant, can therefore
be reassuring to the referring clinician.
• Recognition of its existence leads to the correct
diagnosis of right abdominal palpable mass, or
correct depiction of the tumors within the lowest
part of the elongated normal liver.

11. Clinical significance
• It may harbor a lesion that might not be
demonstrated unless the most inferior aspect of
the liver is imaged
• a case of gastric outlet obstruction due to a
Riedel's lobe has been reported.
• Torsion of riedel’s lobe was reported

12. Clinical significance
• importance of having knowledge or suspicion
of its possibility.
• Riedel's lobe can also pose a challenge during
right-sided laparoscopic procedures
• Riedel's lobe presented as an obstruction
during right renal surgery

13. Videos on Web
• www.youtube.com/ search as saravanamuthu
Marimuthu
• More than 30 videos
• More than 30,000 viewers
• View our Presentations in slidesharenet

14. Our Team-Tumor board Members
• Dept of Surgical Oncology
 Dr.S.Marimuthu, MS., DNB.,MCh
• Dept of Medical Oncology
 Dr.S.Suresh., MD(RT),DM(Med.Onco)
• Dept of Radiation Oncology
 Prof.G.L.Murugavel
 Dr.K.Shanti
 Dr.R.Vijayakumar
• Dept. of OncoPathology
 Dr.K.G.padmanaban
 Dr.Shanthi

15. THANK YOU