Article Text

Download PDFPDF
Case report
Falciform ligament appendagitis after Roux-en-Y bypass surgery mimicking acute cholecystitis
  1. Lee K Rousslang,
  2. McHuy F McCoy and
  3. C Frank Gould
  1. Department of Radiology, Tripler Army Medical Center, Medical Center, Hawaii, USA
  1. Correspondence to Dr Lee K Rousslang; lee.k.rousslang.civ{at}


Fatty falciform ligament appendage torsion (F-FLAT) is a rare type of intraperitoneal focal fat infarction that involves torsion of a fatty appendage of the falciform ligament. It may cause severe pain, mimicking an acute abdomen, but is typically self-limited and does not require hospitalisation or surgery. As a type of intraperitoneal focal fat infarction, it shares many of the same physiological, clinical and radiological features of epiploic appendagitis. To our knowledge, F-FLAT has not previously been reported in a patient following a laparoscopic Roux-en-Y gastric bypass surgery. Identifying falciform ligament appendagitis is critical because it can prevent unnecessary hospitalisation, follow-up studies and surgery.

  • hepatitis other
  • obesity (public health)
  • radiology
  • general surgery
View Full Text

Statistics from


  • Contributors As lead author, I, LKR, performed the majority of the writing and background research involved with the manuscript, including the summary, background, case presentation, differential diagnosis, treatment, outcome, discussion and learning points. MHFM helped with the literature search and edited the manuscript, including the addition of his own written contribution in the background, case presentation and discussion. He also performed the initial CT interpretation. CFG oversaw the entire process, finalised the radiological reads involved, provided edits including his own writing in the manuscript and also determined the important aspects of the case to be highlighted, including writing in the case presentation, discussion and learning points.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the United States Government. The authors have no financial, personal or other vested interests in the information contained within this document.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.