Primary torsion of the falciform ligament: Computed tomography and ultrasound findings

Abstract

Torsion of the free end of the falciform ligament is an extremely rare cause of localized peritonitis. A surgically proven case is presented here, with ultrasound and CT findings and a review of the published work.

Unusual Cause of Epigastric Pain: Intra-Abdominal Focal Fat Infarction Involving Appendage of Falciform Ligament - Case Report and Review of Literature

“…Usually, conservative treatment is adequate, but a few of the reported cases have been operated, primarily due to lesser awareness about the condition and its usually self-limiting nature [5,6,9] . Another reason for laparotomy was due to the possibility of necrosis and gangrene as seen in some reports [2] .…”

Contribution of us and ct for diagnosis of intra peritoneal focal fat infarction (iffi): a pictorial review

“…The falciform ligament (FL) is formed by two layers of peritoneum and contains a variable amount of extraperitoneal fat along with the remnants of the umbilical vein and (10). Starting at the umbilicus in the midline, it passes to the right of the midline to connect the liver at the level of the accessory fissure.…”

“…Surgical lesions implicating the FL are extremely uncommon and are represented by the rare internal hernia through the ligament, cystic lesions -primary congenital cysts or secondary infectious, neoplastic or identifying the lesion as separate from the surrounding structures (10) and US may be useful to demonstrate the fact that the lesion doesn't move with breathing, thereby proving its superficial extraperitoneal nature (14) ( Fig. 9).…”

“…Torsion of the FL or of a lipomatous appendage of the FL is a very rare cause of acute abdominal pain and only five cases have been described as separate case reports (10,14). The presentation is very similar to omental torsion with localized peritonism without fever or elevated white cell count and the differential diagnosis has to be made essentially with cholecystitis and perforated gastroduodenal ulcer.…”

The falciform ligament and the ligamentum teres: friend or foe

“…Vascular insufficiency and haemorrhage of the falciform have been reported in the literature as a rare cause of abdominal pain 5 . Haemoperitoneum has been reported in association with vomiting and also secondary to traction during laparoscopic surgery.…”