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Case report of falciform ligament abscess—The importance of early diagnosis. Radiol Case Rep 2022; 17:4608-4612. [PMID: 36193268 PMCID: PMC9525812 DOI: 10.1016/j.radcr.2022.08.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/20/2022] [Indexed: 11/21/2022] Open
Abstract
Ligaments are peritoneal duplications that contain venous and lymphatic vessels that can potentially be pathways for the spread of infection. Primary inflammation of one of the peritoneal ligaments is very rare. Abscess of the falciform ligament (FLA) is a rare pathological substrate whose pathophysiology is still unknown or poorly understood, but most often occurs as a consequence of a local inflammatory process such as acute cholangitis, cholecystitis, pancreatitis or pylephlebitis. The diagnosis of the primary site of inflammation as well as FLA is established by radiological methods—ultrasound (US), computed tomography (CT) and magnetic resonance (MR), while the therapy is most often combined—conservative and surgical, but interventional radiology methods can also be used. In this report, we present a 67-year-old patient with the falciform ligament abscess that developed during epizode of acute cholecystitis with left portal vein thrombosis, which was diagnosed by US and CT and effectively managed with antibiotic treatment. FLA is a severe inflammatory condition that requires prompt diagnosis and aggressive antibiotic therapy to avoid surgical treatment.
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Oelhafen K, Shayota BJ, Muhleman M, Klaassen Z, Shoja MM, Tubbs RS, Loukas M. Peritoneal Bands: A Review of Anatomical Distribution and Clinical Implications. Am Surg 2012. [DOI: 10.1177/000313481207800424] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The complexity of embryological development of the gastrointestinal tract and mesentery provides a platform for the formation of a wide variety of variant veils, folds, and membranes, collectively termed peritoneal bands. These structures, which represent anatomically unabsorbed portions of the omentum and mesentery, although often benign, have the potential to cause clinically significant manifestations in both the neonate and adult. Although these deviant structures may be identified over a broad range of the abdominal cavity, they are most commonly identified in the regions of the duodenum, duodenojejunal flexure, ileocecal junction, and ascending colon. As a result of the diverse location of these variant structures, clinical manifestations are highly variable, ranging from acute presentations of intestinal necrosis as a result of strangulated midgut volvulus to chronic, vague abdominal pain. This article seeks to highlight the importance of a thorough anatomical understanding of the distribution of the various abnormal peritoneal folds, bands, and ligaments, which may result from aberrations in embryonic gastrointestinal development and their respective clinical implications. Moreover, to advance the knowledge of peritoneal bands, this article discusses the appropriate diagnostic studies and treatment interventions required for these variant structures.
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Affiliation(s)
- Kim Oelhafen
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Brian J. Shayota
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Mitchel Muhleman
- St. George's University School of Medicine, St. George's, Grenada, West Indies
| | - Zachary Klaassen
- St. George's University School of Medicine, St. George's, Grenada, West Indies
- Department of Surgery, Saint Barnabas Medical Center, Livingston, New Jersey
| | | | - R. Shane Tubbs
- Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama
| | - Marios Loukas
- St. George's University School of Medicine, St. George's, Grenada, West Indies
- Department of Anatomy, Medical School Varmia and Mazuria, Olsztyn, Poland
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Wen YL, Kudo M, Chung H, Minami Y, Suetomi Y, Onda H, Kitano M, Kawasaki T, Maekawa K. Agenesis of the left lobe of the liver: Radiologic findings. J Med Ultrason (2001) 2001. [DOI: 10.1007/bf02481355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Two cases of abdominal abscesses related to the falciform ligament are described. The importance of ultrasonic localization is stressed, as these extrahepatic abscesses require surgical drainage, whereas an intrahepatic abscess, particularly amoebic, may be treated with antimicrobials.
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