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Case Reports
. 2022 Jan 17;2022(1):rjab150.
doi: 10.1093/jscr/rjab150. eCollection 2022 Jan.

Falciform ligament torsion as a rare aetiology of the acute abdomen

Adam O'Connor  1 , Shariq Sabri  2 , Maseera Solkar  3 , Amaila Ramzan  2 , Mamoon Solkar  2
Affiliations
Case Reports

Falciform ligament torsion as a rare aetiology of the acute abdomen

Adam O'Connor et al. J Surg Case Rep. .

Abstract

The falciform ligament is a remnant of the embryonic ventral mesentery containing the obliterated umbilical vein and round ligament. It extends from the umbilicus to the superior aspect of the diaphragm. We report about a 53-year-old fit and well patient who presented with acute upper abdominal pain with tenderness to palpation. Ultrasound scan was unremarkable, but blood tests revealed raised inflammatory markers. Thus, computed tomography was performed. This demonstrated acute torsion and fat necrosis of the falciform ligament, which was the aetiology of the upper abdominal pain. Such pathology is rare with 23 previously reported cases. Conservative management is usually proposed, but on occasion, surgical intervention may be warranted in cases that do not respond to initial supportive measures. We describe this case to demonstrate a rare cause of a common presentation to the surgical service.

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Figures

Figure 1
Figure 1
Contrast-enhanced CT scan shows a 32 × 22-mm oval-shaped fat density lesion with peripheral hyperattenuation and central hyperdense dot adjacent to falciform ligament. There is surrounding oedema and inflammation. Gall bladder is noted to be unremarkable. Features represent intraperitoneal focal fat infarction of fatty appendage of falciform ligament.
Figure 2
Figure 2
Sagittal reconstruction redemonstrates central hyperdense thrombosed vessel secondary to torsion
See this image and copyright information in PMC

References

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