Infarction of torsed lipomatous appendage of the falciform ligament

Résumé

A 46-year-old male presented with sudden onset of severe pain in the right upper quadrant. On abdominal examination, a well-defined point of focal tenderness and a subtle lump were evident. Abdominal x-ray, ultrasound and laboratory tests were unremarkable. An abdominal CT scan was then requested, showing fat stranding and a torsed appearance of a lipomatous appendage of the falciform ligament, compatible with infarction. The pathophysiology of this entity is similar to the more commonly seen omental infarction and epiploic appendagitis, encompassing the spectrum of intra-abdominal focal fat infarction that has recently been described.