AIM: report a new case of primary necrosis of the ligamentum teres hepatis and discuss preoperative diagnosis strategy and therapeutic options. OBSERVATION: This is a patient of 76 years, hypertensive, who was admitted for an acute abdomen. The diagnosis of acute pancreatitis was referred to the poor clinical examination and amylase to six times normal. Abdominal CT scan showed a normal pancreas appearance and hypodense infiltration extended along the round ligament of the liver to the anterior abdominal wall that did not take the contrast. The patient was operated 24 hours after admission to the signs of clinical and biological severity. There was gangrene of the round ligament and the suspensory ligament of the liver. We performed a resection of all necrotic tissue and cholecystectomy. The postoperative course was uneventful. CONCLUSION: Primary necrosis of the round ligament of the liver is an extremely rare cause acute abdomen. Its diagnosis is difficult despite the contribution of the abdominal CT scan. Treatment is surgical.
AIM: report a new case of primary necrosis of the ligamentum teres hepatis and discuss preoperative diagnosis strategy and therapeutic options. OBSERVATION: This is a patient of 76 years, hypertensive, who was admitted for an acute abdomen. The diagnosis of acute pancreatitis was referred to the poor clinical examination and amylase to six times normal. Abdominal CT scan showed a normal pancreas appearance and hypodense infiltration extended along the round ligament of the liver to the anterior abdominal wall that did not take the contrast. The patient was operated 24 hours after admission to the signs of clinical and biological severity. There was gangrene of the round ligament and the suspensory ligament of the liver. We performed a resection of all necrotic tissue and cholecystectomy. The postoperative course was uneventful. CONCLUSION: Primary necrosis of the round ligament of the liver is an extremely rare cause acute abdomen. Its diagnosis is difficult despite the contribution of the abdominal CT scan. Treatment is surgical.