Perigastric appendagitis of the falciform ligament
Previously healthy female, presented with two days of epigastric pain without fever or relation to meals. Mild right upper quadrant tenderness was noted on physical examination. Blood tests showed mild leukocytosis (11,300/mm3), with normal CRP and liver enzymes.
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CT scan showed a streaky fat stranding around falciform ligament, without any other acute pathology on the scan.
We present a case of falciform fat appendagitis as a cause of epigastric pain.
Perigastric appendagitis is a rare clinical entity, with similar pathophysiology to intraperitoneal focal fatty infarction, including omental infarction and epiploic appendagitis.
The typical sites are the gastrohepatic, gastrosplenic and falciform ligaments.
Courtesy of Dr.Leonid Goldberg and Dr.Yair Halpern.
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