Cyanoacrylate injection complications: septic emboli and abscess within the falciform ligament - a case report

Abstract

Background: Falciform ligament abscesses are uncommon. The few cases reported in the literature are associated with infectious or inflammatory conditions such as acute cholecystitis and omphalitis in pediatric patients. However, it has only been rarely described as a complication for some therapeutic procedures. Case Presentation: A 23-year-old female with primary portal vein thrombosis, portal hypertension, and gastric varices with a history of upper gastrointestinal bleedings. The last episode required cyanoacrylate injection. After administering the injection, septic emboli obstructed the splenic vein causing the recanalization and thrombosis of the paraumbilical veins. Therefore, an abscess formed within the falciform ligament. The treatment consisted of surgical drainage and antibiotics. Conclusion: Diagnosis of falciform ligament abscesses requires a high degree of clinical suspicion and vast knowledge of anatomy. It is important to recognize its pathophysiology and consider the possible differential diagnosis to offer the best approach and treatment for its underlying cause.