Falciform Ligament Abscess after Omphalitis: Report of a Case

Moon, Sun-Young; Lee, Hae Won; Park, Kwi Won; Jung, Sung-Eun

doi:10.3346/jkms.2010.25.7.1090

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…It has been observed that infection can extend from liver, gallbladder or umbilicus to the falciform ligament. [2][3][4][5][6] Though in this case it was found that gallbladder was not acutely inflamed and no infective lesion was present in the abdominal cavity. Here, relationship with chronic cholecystitis could not be established.…”

Section: Discussionmentioning

confidence: 55%

“…After two months there was a recurrence of the abscess of falciform ligament secondary to acute calculous cholecystitis. 2 Other few cases of this condition have been reported in the setting of rupture of the gangrenous gallbladder, 3 portal pyemias, 4,5 post omphalitis, 6,7 post pancreatitis, 8 and infected ventriculoperitoneal shunt. 9 There is one case of an isolated falciform ligament necrosis presenting as acute abdomen has also been reported.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Falciform Ligament Abscess with Unknown Etiology

Jain¹,

Hadiyal²,

Jolly³

et al. 2018

World Journal of Laparoscopic Surgery With DVD

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The incidence of a falciform ligament is very rare. Because of the rarity of the condition and sparsity of available literature, it's very difficult to diagnose this condition preoperatively. In this case, a 65-year-old lady had presented with pain in epigastrium and vomitings for 3 days. All blood investigations were normal except serum Alkaline phosphatase (ALP) and serum gamma-glutamyl transferase (GGT) which were 141 IU/L and 275 U/L respectively. USG revealed only chronic cholecystitis. On diagnostic laparoscopy, falciform ligament abscess was detected which was adequately drained. The patient responded well with the drainage without recurrence till date. Laparoscopic cholecystectomy was also done in the same sitting.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Falciform Ligament Abscess with Unknown Etiology

Jain¹,

Hadiyal²,

Jolly³

et al. 2018

World Journal of Laparoscopic Surgery With DVD

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“…In the literature, preoperative CT findings were confirmed intraoperatively. These findings included falciform ligament abscess [4], desmoid tumor appended to the round ligament [5], and infiltration of the round ligament [6].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous inflammation and necrosis of the falciform and round ligaments: a case report and review of the literature

2020

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Background: Necrosis of the falciform and round ligaments is extremely rare, thus making the diagnosis challenging. It is often misdiagnosed as gallbladder pathology due to the presenting symptoms. Due to the rarity of this pathology, there is limited literature available. Case presentation: A 53-year-old white man presented to our hospital with signs and symptoms of gallbladder pain but turned out to have the rare entity of necrosis of the falciform and round ligaments. An extensive review of the world literature was performed using PubMed. Manual cross-referencing of reference lists was performed to obtain all available articles. The personal operative log of the senior author was also searched to reveal one additional case. Statistical analysis was descriptive only, given the small number of reported cases. Thirty-nine articles were found, among which forty-three case were identified, and one additional case was extracted from the operative log of the senior author. Unlike previous reports, we found that isolated inflammation and necrosis of the ligaments occurs at nearly the same frequency in both men and women, not predominantly in women as previously reported in smaller series. The mean age at presentation was 59.5 years old, and cases were typically initially diagnosed as gallbladder pathology, most commonly acute cholecystitis. Computed tomography more frequently than ultrasound revealed the falciform and round-ligament pathology. Conclusions: Isolated falciform and round-ligament inflammation and necrosis is a rare condition that is difficult to diagnose because it can present mimicking a wide variety of intra-abdominal pathologies, particularly gallbladder pathologies. It is often best treated by laparoscopic resection. Unlike prior reports, our review of the literature, which is the largest that we know of to date, shows that males and females are equally affected. Greater awareness of this entity will aid in future diagnosis.

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“…This venous network might explain the mechanism of spread of infection from omphalitis into the falciform ligament in the absence of a round ligament (post-operative cases). 7 The cholecystic veins drain directly into the portal vein and the pericholedochal venous system. It is likely that the infection spreads from the biliary tree via the paraumbilical veins to the falciform ligament, leading to abscess formation.…”

Section: Discussionmentioning

confidence: 99%

The “sausage” abscess: abscess of the liagamentum teres hepatis

Sen¹,

Arora²,

Sohal³

et al. 2016

BJR|case reports

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An abscess of the ligamentum teres hepatis is a very rare cause of acute abdomen and can present a diagnostic dilemma. A 40-year-old diabetic male presented with obstructive jaundice and cholangitis. An ill-defined, sausage-shaped, tender parasagittal supraumbilical mass was palpable on the right side. Murphy’s sign was negative. Laboratory investigations revealed polymorphonuclear leukocytosis (total leukocyte count 19,000 mm–3), elevated alkaline phosphatase (400 IU l–1), conjugated hyperbilirubinaemia (16 mg dl–1) and elevated blood glucose (240 mg dl–1). Ultrasonography and MR cholangiopancreatography revealed cholecystolithiasis, obstructive choledocholithiasis, abscess of the ligamentum teres hepatis and left portal thrombosis. Under ultrasound guidance, pus was aspirated from the abscess and the patient was started on broad-spectrum intravenous antibiotics, insulin and low-molecular-weight heparin. He subsequently underwent endoscopic retrograde cholangiopancreatography with sphincterotomy and stone extraction. On the tenth day post admission, he underwent laparoscopic cholecystectomy and excision of the ligament. The patient made an uneventful recovery and was discharged on the seventh post-operative day. On follow-up, the patient remained asymptomatic with normal biochemical parameters. This article highlights the importance of suspecting and identifying an abscess of the ligamentum teres hepatis when a patient with acute abdomen presents with a sausage-shaped right parasagittal mass, especially in the setting of cholangitis, cholecystitis or omphalitis.

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Falciform Ligament Abscess after Omphalitis: Report of a Case

Cited by 15 publications

References 9 publications

A Rare Case of Falciform Ligament Abscess with Unknown Etiology

A Rare Case of Falciform Ligament Abscess with Unknown Etiology

Spontaneous inflammation and necrosis of the falciform and round ligaments: a case report and review of the literature

The “sausage” abscess: abscess of the liagamentum teres hepatis

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