J Korean Soc Radiol.  2018 Nov;79(5):271-275. 10.3348/jksr.2018.79.5.271.

Minimally Invasive Treatment of Falciform Ligament Abscess in a 25-Day-Old Neonate: A Case Report

• Lee MA
• Lee JS
• Lee MS
• Kim SH
• Lee KR
• Kim YJ
• Kang KS

• KMID: 2422904
• DOI: http://doi.org/10.3348/jksr.2018.79.5.271

Abstract

The falciform ligament is a hepatic suspensory ligament that extends from the umbilicus to the diaphragm, containing the ligamentum teres and a vestigial remnant of the umbilical vein. Among the rarely-occurring pathologies of the falciform ligament, which include ligament cyst, tumor, abnormal vascularization, and congenital ligament defect, a falciform ligament abscess is even more sporadic. Accordingly, the definitive diagnosis of the falciform ligament abscess is rather challenging and may easily be misinterpreted as an infected choledochal cyst or a liver abscess. We present a 25-day-old infant with the falciform ligament abscess, which developed after the umbilical venous catheter insertion and was successfully treated with percutaneous drainage and antibiotic administration.

MeSH Terms

Abscess*
Catheters
Choledochal Cyst
Diagnosis
Diaphragm
Drainage
Humans
Infant
Infant, Newborn*
Ligaments*
Liver Abscess
Pathology
Round Ligaments
Umbilical Veins
Umbilicus

Figure

• 

  Fig. 1 Falciform ligament abscess in a 25-day-old neonate with minimal invasive treatment. A. A round and heterogenous mass (arrows) between the quadrate and left lobes of the liver continues with thickened and hyperechoic ligamentum teres (dashed arrows), which extends to the abdominal wall on the trans-abdominal ultrasound. B. Consecutive contrast-enhanced CT images of the falciform ligament abscess. A well-defined, hypodense mass with the peripheral thick enhancing wall (arrows) between the quadrate and left lobes of the liver, and the lower part of the mass extends to the abdominal wall. C. Percutaneous catheter drainage is performed for the falciform ligament abscess. D. A follow-up trans-abdominal ultrasound one month after catheter removal. The falciform ligament abscess is completely regressed and a small echogenic focus (arrows) is only left between the quadrate and left lobe of the liver.

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