The properitoneal fat pad associated with the falciform ligament. Imaging of extent and clinical relevance.

The configuration of the constant properitoneal body of fat with contained vasculature (ensiform vessels and portions of the ligamentum teres) and its relationship to the falciform ligament were studied by reviewing 122 computer tomographic scans of 103 patients with ascites. The maximal width was found in 57% at the level of the intrahepatic ligamentum teres immediately after entry into the liver but maximal thickness was mostly found higher up. Our measurements of mean maximal width and thickness of 7.2 cm and 1.2 cm respectively, corresponded well with dissection findings in the literature. A variety of pathologic conditions can affect the fat pad via connecting or adjacent structures like the falciform ligament, lesser omentum, properitoneal flank fat, mediastinal fat or transperitoneally. However, involvement by pathology was infrequent.