Clinics in diagnostic imaging (203). Focal infarction of the falciform ligament fatty appendage

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.