Gangrene of the hepatic ligaments is rare and easily misdiagnosed.
Round ligament = ligamentum teres hepatis. It runs from the umbilicus to the liver and is the remnant of the fetal umbilical vein.
The falciform ligament is a thin piece of connective tissue that connects the liver to the anterior abdominal wall and the diaphragm.
Clinical presentation:
(1) epigastric or generalized peritoneal signs with pain and distension
(2) nausea and vomiting
It may be misdiagnosed as cholecystitis or perforated peptic ulcer.
The condition is often first suspected in imaging studies as a hyperechogenic or hypodense focal lesion in the ligament. Diagnosis typically is done at or following surgery.
Possible causes may include:
(1) trauma
(2) rupture of a hepatic abscess
(3) spread along the umbilical vein remnant
Complications:
(1) peritonitis
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