1/5. Isolated gangrene of the round and falciform liver ligaments: a rare cause of peritonitis: case report and review of the world literature.Isolated infection and/or gangrene of the round and falciform liver ligaments is among the rarest causes of acute abdomen. The diagnosis is based on demonstrating localized or patchy inflammatory or gangrenous changes in the ligaments without apparent etiology. We report the case of an 18-year-old male who presented with a 24-hour history of generalized abdominal pain and distention, nausea, and vomiting. With a preoperative diagnosis of probable perforated duodenal ulcus and generalized peritonitis the patient underwent emergency surgery. Multiple patchy gangrenous areas of the round and falciform ligaments were found starting from the umbilicus up to the hepatic hilum. The ligaments were resected in toto. The patient's postoperative course was unremarkable. No apparent etiology of the condition was found. We provide the first extensive review of the world literature. Isolated infection and/or gangrene of the round and falciform liver ligaments should be suspected in patients with upper abdominal complaints when imaging studies demonstrate ligament abnormality, tumor, or fluid. Treatment is only surgical. Depending on surgeon's expertise, patient's condition, and severity and extent of disease either open or laparoscopic surgery may be performed.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/5. The femoropopliteal segment as a source of peripheral atheroembolism.The concept of atheromatous embolisation from ulcerated plaques in non-aneurysmal arteries is well recognised but little attention has been paid to lesions in arteries below the inguinal ligament as a source of emboli. Twenty eight of 42 patients (66%) who presented with atheroembolism to the lower limbs had an embolic source in the femoropopliteal segment, with only a third with an identifiable source lesion in the aorta or iliac vessels. A characteristic clinical presentation, combined with a typical appearance on arteriography, usually allows a confident diagnosis to be made, yet many of these patients still have their ischaemic symptoms and signs wrongly attributed to occlusive disease. Successful management depends on early recognition and correction of the source lesion. The treatment of choice is a bypass procedure with appropriate vessel ligation. The majority of ischaemic lesions recover, or the damage is limited to minor digital amputations which will heal primarily. Surgical correction is successful in preventing further embolic episodes.- - - - - - - - - - ranking = 0.1keywords = ligament (Clic here for more details about this article) |
3/5. Gangrenous ligamentum teres hepatis causing acute abdominal symptoms.This unusual case of a gangrenous round ligament manifested by acute abdominal symptoms underscores the importance of the recent radiologic descriptions of the round ligament in computerized tomography and ultrasonography. The cause of the gangrenous process in this case remains unresolved.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |
4/5. Internal hernia and gangrenous intestine. A rare complication of a femoral--femoral bypass graft.An unusual case of an internal hernia related to a retropubic femoral-femoral bypass graft is presented. An orifice between the left and right inguinal ligaments and a protruding intraperitoneal portion of the prosthetic graft material resulted in herniation and strangulation of a portion of the small intestine. Technical factors (graft redundancy or misplacement) and natural factors (pulsatile erosion or age elongation) may be implicated. The potential for this complication exists in all grafts currently placed. The subcutaneous location appears to be a better technique.- - - - - - - - - - ranking = 0.1keywords = ligament (Clic here for more details about this article) |
5/5. Falciform ligament aperture causing intestinal strangulation.In rare cases intestinal obstruction may be caused by herniation of small bowel through a defect in the falciform ligament. Such a case was that of a 28-year-old woman who had a 26-week twin pregnancy. She had acute upper abdominal pain. The diagnosis was acute appendicitis, but at operation a loop of ileum was found to have passed through an aperture in the falciform ligament. The loop was gangrenous and required resection. Her course was complicated by delivery of two infants on the day after operation; one died within a few hours and the other 4 months later. The patient recovered after a second operation 2 weeks later for small bowel obstruction due to adhesions. Only six other patients with this anomaly have been reported. Two were neonates. Three patients died. This complication of pregnancy has not been described before. Dislocation of the small intestine by the enlarged uterus may have contributed to the herniation. Prompt operation is mandatory in this condition as in any case of closed-loop bowel obstruction.- - - - - - - - - - ranking = 0.6keywords = ligament (Clic here for more details about this article) |