Absence of the Falciform and Triangular Ligaments of the Liv
Case presentation
An 18-year old woman began to experience episodic abdominal pain about eight months previously. At that time, she was about three weeks post-partum. At the time of admission, she had an attack of more severe right upper quadrant pain and pressure radiating to her back. There was nausea and vomiting. No other bowel symptoms were mentioned. There were no chills or fever. A liver function panel was normal. Abdominal ultrasound showed gallstones and a common bile duct diameter of 8 mm. On exam, she was afebrile and did not appear jaundiced. She had right upper quadrant tenderness.
At operation, she was noted to have no ligamentous attachments to the upper surface of the liver. (Figure 1) The falciform ligament and both left and right triangular ligaments were absent. The round ligament of the liver separated from the anterior midline several centimeters above the umbilicus. It entered the inferior surface of the liver in the usual location as a thick cord-like structure encased in fat.(Figures 2,3)...