J Korean Med Sci.  2010 Jul;25(7):1090-1092. 10.3346/jkms.2010.25.7.1090.

Falciform Ligament Abscess after Omphalitis: Report of a Case

• Moon SB
• Lee HW
• Park KW
• Jung SE

• KMID: 1792964
• DOI: http://doi.org/10.3346/jkms.2010.25.7.1090

Abstract

A falciform ligament abscess is a rare type of intra-abdominal abscess. A 2-yr-old male, who had omphalitis two months previously, presented with a fever and right upper quadrant abdominal pain. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver, which was refractory to conservative management with percutaneous draninage and antibiotics. On the third recurrence, surgical exploration was performed and revealed an abscess arising from the falciform ligament; the falciform ligament was excised. A follow up ultrasound confirmed complete resolution of the abscess with no further recurrence.

Keyword

Falciform; Ligaments; Abscess; Omphalitis

MeSH Terms

Abdominal Abscess/*etiology/surgery
Child, Preschool
Humans
Infection/*complications
Ligaments/*pathology/surgery
Male
Umbilicus/*pathology

Figure

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  Fig. 1 The CT scan showing an abscess pocket with thick irregular wall at right paramedian abdominal wall, abutting to the falcifom ligament.

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  Fig. 2 The falciform ligament abscess was completely excised from the abdominal wall.

Reference

1. Mori H, Aikawa H, Hirao K, Futagawa S, Fukuda T, Maeda H, Hayashi K. Exophytic spread of hepatobiliary disease via perihepatic ligaments: demonstration with CT and US. Radiology. 1989. 172:41–46.

2. de Melo VA, de Melo GB, Silva RL, Aragão JF, Rosa JE. Falciform ligament abscess: report of a case. Rev Hosp Clin Fac Med Sao Paulo. 2003. 58:37–38.

3. Sones PJ Jr, Thomas BM, Masand PP. Falciform ligament abscess: appearance on computed tomography and sonography. AJR Am J Roentgenol. 1981. 137:161–162.

4. Lipinski JK, Vega JM, Cywes S, Cremin BJ. Falciform ligament abscess in the infant. J Pediatr Surg. 1985. 20:556–558.

5. Losanoff JE, Kjossev KT. Isolated gangrene of the round and falciform liver ligaments: a rare cause of peritonitis: case report and review of the world literature. Am Surg. 2002. 68:751–755.

6. Snell RS. Clinical anatomy. 2004. 7th ed. Philadelphia, PA: Lippincott Williams&Wilkins.

7. Sawardekar KP. Changing spectrum of neonatal omphalitis. Pediatr Infect Dis J. 2004. 23:22–26.

8. Cilley RE. Grosfeld JL, O'Neill JA, Fonkalsrud EW, Coran AG, editors. Disorders of the umbilicus. Pediatric Surgery. 2006. 6th ed. Philadelphia, PA: Mosby;1143–1156.

9. Pratap A, Tiwari A, Anchal N, Agrawal CS, Shreshta P, Shakya VC. Falciform ligament abscess with portal pyemia in a newborn. J Pediatr Surg. 2006. 41:1473–1475.

10. Laucks SS 2nd, Ballantine TV, Boal DK. Abscess of the falciform ligament in a child with a ventriculoperitoneal shunt. J Pediatr Surg. 1986. 21:979–980.