Atif Qurrat Al Ain, Khaliq Tanwir
Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad.
J Coll Physicians Surg Pak. 2015 Nov;25(11):837-8.
Pathologies of the falciform ligament are extremely rare entities ranging from cyst and hematoma to abscess and gangrene. Intestinal obstruction, secondary to extensive falciform ligament abscess, has not been reported to date. On account of being rare, diseases of falciform ligament have perplexing presentations leading to unwanted delays in diagnosis and management. These may present with abdominal wall ecchymoses (Cullen's sign - pancreatitis, portal hypertension), an abdominal mass, features of abscess, intestinal obstruction or peritonitis. Abscess may be an indicator of underlying liver or biliary pathology. Appreciating these as important differentials while working up patients with similar features, would markedly reduce missed diagnoses and improve surgical management. We present the case of a 40-year Pakistani gentleman who had duodenal obstruction owing to the presence of falciform ligament abscess resulting from a rather ignored episode of pancreatitis, mimicking malignancy.
镰状韧带病变极为罕见，包括囊肿、血肿、脓肿和坏疽等。迄今为止，尚未有因广泛的镰状韧带脓肿继发肠梗阻的报道。由于较为罕见，镰状韧带疾病的表现令人困惑，导致诊断和治疗出现不必要的延误。这些疾病可能表现为腹壁瘀斑（卡伦征——胰腺炎、门静脉高压）、腹部肿块、脓肿特征、肠梗阻或腹膜炎。脓肿可能是潜在肝脏或胆道病变的指标。在对具有相似特征的患者进行检查时，将这些情况视为重要的鉴别诊断，可显著减少漏诊并改善手术治疗。我们报告一例40岁的巴基斯坦男性病例，该患者因胰腺炎发作被忽视，导致镰状韧带脓肿，进而引起十二指肠梗阻，酷似恶性肿瘤。
