Postpancreatitis Abscess of Falciform Ligament: An Unusual Presentation

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.