Fatty falciform ligament appendage torsion (FFLAT) is a rare phenomenon as there are only two reported pediatric cases of falciform ligament fatty appendage torsion in the literature. In this case, the diagnosis was established via ultrasound (US) and confirmed with computed tomography (CT). US showed an echogenic, ill-defined mass in the epigastric region that extending into the falciform ligament. CT showed the “hyperattenuating rim” sign. This report is the first reported female pediatric case of FFLAT that was diagnosed with US and CT, given a trial of analgesics, and definitively cured via minimally invasive surgical excision. A 13-year-old female presented to the emergency department with episodic waxing and waning abdominal pain for three days. The pain had localized to the mid-epigastrium and worsened with deep inspiration. On examination, vital signs were within normal limits. Focal tenderness was elicited upon palpation of the epigastrium. Laboratory evaluation revealed a mild leukocytosis 14.2 x 109/L, normal range (3.9-10.6 x 109/L).
SPR 2019 Annual Meeting & Postgraduate Course
Fatty appendage torsion