Case Report
Volume 9 Issue 1 - 2022
Unusual Case: Abdominal Pain Syndrome Secondary to Congenital Defect of the Round Ligament of the Liver in an Adult Patient
Mauro Garibaldi Bernot*, Francisco José de la Vega González, Raúl Alvarado Bachmann and Gonzalo Hagerman Ruíz-Galindo
Surgery Resident, American British Cowdray Medical Center, CDMX
*Corresponding Author: Gonzalo Hagerman Ruíz-Galindo, Surgery Resident, American British Cowdray Medical Center, CDMX.
Received: November 19, 2021; Published: December 30, 2021




Abstract

Introduction: Falciform/ round liver´s ligament defects are uncommon, have various clinical features that they can cause, and are generally diagnosed intraoperatively. Currently, abdominal tomography is performed routinely in the emergency room, it can help in the preoperative diagnosis and guide the therapeutic attitude to be performed, but currently, there are no characteristic tomographic data of this pathology. There are few published cases in the literature, and these were generally diagnosed at a late stage and were mostly among adults.

Presentation of case: We present a 45-year-old female patient who presented with acute abdominal pain to the emergency room. The patient had never undergone abdominal surgery.

Discussion: On diagnostic laparoscopy found the transverse colon and small intestine (duodenum) crossing a foramen in the liver's round/ falciform ligament. The obstruction was resolved by dividing part of the ligament without intestinal resection.

Conclusion: All structural entrapments caused by the falciform/ round liver's ligament are produced by an abnormal fixation process of the anterior peritoneum in its embryonic stage. The most common clinical presentation associated with these defects is intestinal obstruction. We propose the term "inclusion in the falciform/ round liver's ligament " as a concept to encompass these clinical presentations of pain, occlusion, or other digestive pathology, which are accompanied by an abnormal fixation of structures of the digestive system towards the falciform/ round liver's ligament. An accurate diagnosis is only possible under direct vision in surgery, where, in addition to being diagnostic, it is therapeutic.

Keywords: Thickening and Shortening of the Round Ligament of the Liver; Falciform ligament; Falciform Window; Round Ligament of the Liver; Congenital

References

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  3. Santa L. “Painful epigastric syndromes caused by abnormal shortness of the round ligament of the liver”. Minerva Chirurgica 10 (1955): 888-891.
  4. Sampliner JE and Lee YC. “Small-bowel obstruction due to congenital anomaly of the falciform ligament”. Archives of Surgery 111 (1976): 200.
  5. Levantovskii BV and Lebedev NV. “Strangulation of the small intestine at the foramen of the round ligament of the liver”. Vestnik khirurgii imeni II Grekova 152 (1994): 50-51.
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  8. Davies CJ and Franks RE. “Herniation through a defect in the falciform ligament”. Guy's Hospital Reports 123 (1974): 171-175.
  9. De Yoe LE and Ianacone JA. “Unusual course and thickening of the round ligament of the liver causing symptoms simulating pyloric stenosis”. The Journal of the Medical Society of New Jersey 48 (1951): 417-418.
  10. Stehr W and Gingalewski CA. “Other causes of intestinal obstruction”. In: Coran A.G., Krummel T.M., Laberge L.M., Shamberger R.C., Caldamone A.A., editors. Pediatric Surgery. Elsevier; Philadelphia (2012): 1127-1134.
Citation: Gonzalo Hagerman Ruíz-Galindo., et al. “Spontaneous Splenic Rupture Under Xarelto”. EC Gastroenterology and Digestive System 9.1 (2022): 01-05.

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