Abscess of the Falciform Ligament Mimicking an Extrahepatic Bile Duct Tumour: a Case Report and Review of the Literature

Abstract

The abscess of the falciform ligament (FL) is a rare condition in adult patients and can occur in the context of acute cholangitis, acute pancreatitis, torsion of the FL itself or spontaneously. Abdominal imaging often helps making a correct diagnosis. We reported a case of FL abscess and the review of the literature. A 78-year-old male was admitted to hospital with acute pancreatitis secondary to hypercholesterolaemia; the computed tomography (CT) scan of the abdomen demonstrated the presence of appendagitis of the FL. After receiving medical treatment, the patient was discharged with planned clinical and radiological follow-up. The magnetic resonance cholangio-pancreatography (MRCP) and abdominal CT scan showed the progression of the inflammatory changes to the porta hepatis, which raised the suspicion of an extrahepatic bile duct tumour; given the diagnostic uncertainty, the patient underwent diagnostic laparoscopy that allowed for the correct diagnosis and treatment. The abscess of the FL is uncommon in adults and radiological findings can be misinterpreted as other clinical conditions; a high index of suspicion is required to formulate a correct diagnosis with the aid of diagnostic laparoscopy.