Chieng Julian Sau Lian, Leow Kheng Song, Lim Tze Chwan
Department of Diagnostic Radiology, Woodlands Health Campus, Singapore.
Singapore Med J. 2020 Jan;61(1):15-18. doi: 10.11622/smedj.2020006.
A 56-year-old man presented to the emergency department with acute upper abdominal pain and mild leucocytosis. The pain was not relieved by intravenous analgesia. Computed tomography of the abdomen and pelvis demonstrated a focal area of fat stranding with a thin peripheral rim of high attenuation and a punctate central hyperdense dot in the vicinity of the falciform ligament. The diagnosis of focal infarction of the falciform ligament fatty appendage was made based on the imaging findings. The patient responded well to conservative management and was discharged for outpatient follow-up. Focal infarction of the falciform ligament fatty appendage is extremely rare and can mimic various causes of acute abdomen that require emergency surgery. Hence, correct radiological diagnosis is essential to avoid unnecessary surgical intervention. We herein discuss the similarities and differences with other common companion cases such as epiploic appendagitis and omental infarction.
一名56岁男性因急性上腹部疼痛和轻度白细胞增多症就诊于急诊科。静脉注射镇痛剂后疼痛未缓解。腹部和盆腔计算机断层扫描显示镰状韧带附近有一个局灶性脂肪条索区域，周围有薄的高衰减边缘，中央有一个点状高密度影。根据影像学表现诊断为镰状韧带脂肪附属器局灶性梗死。患者对保守治疗反应良好，出院进行门诊随访。镰状韧带脂肪附属器局灶性梗死极为罕见，可模仿需要急诊手术的各种急腹症病因。因此，正确的放射学诊断对于避免不必要的手术干预至关重要。我们在此讨论与其他常见伴随病例如网膜附件炎和网膜梗死的异同。
