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An unusual cause of small bowel obstruction: herniation through a defect in the falciform ligament

Cynthia Gingalewski1, Janet Lalikos

  • 1Division of Pediatric Surgery, Children's National Medical Center, Washington, DC 20010, USA. cgingale@cnmc.org

Journal of Pediatric Surgery
|February 19, 2008
PubMed

Insights

Small bowel obstruction in children often results from adhesions. This case highlights a rare strangulated internal hernia around the falciform ligament in a young girl, a first reported instance.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Abdominal Imaging

Background:

  • Small bowel obstruction (SBO) is a common surgical emergency in children.
  • Postsurgical adhesions are the most frequent cause of SBO in pediatric patients.
  • Internal hernias, though rare, represent a significant cause of SBO, particularly around intra-abdominal ligaments.

Observation:

  • A rare case of internal hernia strangulation occurred around the falciform ligament in a pediatric patient.
  • This specific anatomical pathway for internal hernia is infrequently described in pediatric literature.
  • The patient presented with symptoms consistent with acute bowel obstruction.

Findings:

  • The study reports the first documented case of a strangulated internal hernia occurring around the falciform ligament in a child.
  • Surgical intervention was required to address the strangulation and relieve the obstruction.
  • Detailed imaging and surgical findings confirmed the hernia's location and nature.

Implications:

  • This case underscores the importance of considering rare internal hernias in the differential diagnosis of pediatric SBO, even with a history of surgery.
  • Awareness of falciform ligament hernias can aid in timely diagnosis and surgical management, potentially preventing complications like bowel ischemia.
  • Further investigation into the embryological or anatomical factors predisposing to falciform ligament hernias may be warranted.

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