Spontaneous round ligament necrosis. Case report and the review of the literature

Introduction: Necrosis of the round ligament of THE liver is an extremely rare cause of peritonitis, its nonspecific clinical signs frequently causing diagnostic difficulties. For this reason, contrast-enhanced multiphasic CT scan of the abdomen and pelvis is crucial in the diagnostic management.Case report: A 77-year-old male patient with epigastric pain and suspicion of acute cholecystitis was diagnosed with suspected necrosis of the round ligament of the liver on diagnostic imaging. The patient was qualified for surgical treatment. During the laparoscopic procedure, the necrosis of the round ligament of the liver was confirmed, and the necrotic ligament was subjected to laparoscopic resection. The patient was discharged home in good general condition on postoperative day 3.Conclusions: Necrosis of the round ligament of the liver is a rare but clinically significant entity that should be taken into consideration in the differential diagnosis of acute abdomen, particularly presenting with nonspecific symptoms. In most cases, the treatment of choice involves minimally invasive surgical treatment in the form of laparoscopic resection.