Torsed Riedel’s lobe

A 4-year-old boy was admitted with one day history of abdominal pain and fever.The patient had multiple co-morbidities (lipomyelomeningocele, cloacal exstrophy, omphalocele, urethral stenosis, multicystic left kidney, anorectal anomaly, and congenital clubfoot).a Transverse ultrasound image showed a hypoechoic lesion adjacent to the liver, with linear echogenic bands.b Transverse contrast enhanced computed tomography image showed a heterogeneous mass with hyperattenuating areas suggestive of hemorrhage, in contact with the right hepatic lobe and transverse colon.c Intraoperative findings confirmed torsion of a Riedel's hepatic lobe.Torsion of an accessory hepatic lobe is a rare but known cause of an acute abdomen.The presence of a hypoechoic lesion adjacent to the liver, containing echogenic internal bands, should prompt radiologists to consider the diagnosis of accessory hepatic lobe torsion.