Presentation
Right upper quadrant pain for few days.
Patient Data
There is an ovoid fat density with soft tissue rim and adjacent fat stranding in the right anterior upper abdomen with relation to the fissure of the falciform ligament, of concern for torsion of fatty appendage of the falciform ligament.
There is moderate hepatomegaly with diffuse fatty infiltration of the liver.
There is a 4 mm non-obstructing calculus in the lower pole of the right kidney.
Case Discussion
Findings are highly suggestive of torsion of fatty appendage of the falciform ligament which falls under the umbrella of focal intraperitoneal fat infarction.
Intraperitoneal focal fat infarction refers to a group of self-limiting abdominal diseases where the primary insult is acute inflammation of intraperitoneal fat including:
perigastric appendagitis (which is a rare inflammatory/ischemic process involving the perigastric ligaments (gastrohepatic, gastrosplenic, and falciform ligaments)
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