Acute appendagitis of the ligamentum teres hepatis: clinical, ultrasound, and computed tomographic findings

Abstract

Purpose: To describe the clinical, ultrasound (US), and CT findings in three patients with acute appendagitis of the ligamentum teres hepatis.

Methods: A retrospective search of cases over a 4-year period was performed and yielded three patients with acute appendagitis of the ligamentum teres hepatis. The diagnosis was confirmed by US, CT, and clinical follow-up in all three cases. We retrospectively noted the laboratory data, clinical findings, and presumptive clinical diagnosis and describe the US and CT findings.

Results: All three patients presented with severe, circumscribed epigastric pain without other symptoms. The complex reactive protein was not elevated or only mildly elevated. At the spot of maximum pain, US and CT showed all signs of an acute appendagitis; however, the pain was not close to colon, but close to the teres ligament. Symptoms resolved within 1 to 2 weeks without therapy.

Conclusions: Acute appendagitis of the teres ligament is not as rare as previously assumed. Familiarity with the US and CT features enables a reliable diagnosis and prevents unnecessary medical or operative treatment.