Necrosis of Falciform Ligament Complicating a Cholecystitis with a Pylephlebitis and Abscess of the Abdominal Wall

Abstract

Gangrene of the hepatic ligaments (falciform and/or round) is an exceptional and poorly understood condition and may present a diagnostic dilemma. We report a case of necrotic falciform ligament abscess with pylephlebitis secondary to pyocholecyst. The clinical picture was impressive and noisy. The diagnosis was evoked on the CT scan, with the discovery of a circumscribed lesion of fatty density, pre-hepatic, in the fissure of the round ligament, at the junction of segments III and IV of the liver. The interest of surgical exploration is mainly diagnostic insofar as the evolution is always favourable, independently of the modalities of excision of the necrotic zones. In this article, we discuss the diagnostic and therapeutic features of this entit.