Internal herniation through a defect in the falciform ligament: A case report and review of the world literature

Hernia through the falciform ligament accounts for 0.2% of internal hernias. A congenital etiology for these defects is probable. Contributing risk factors include visceral displacement into the upper abdomen and excessive visceral mobility. Patients present most commonly with symptoms of bowel obstruction. Chilaiditi Syndrome on abdominal roentgenograms and abdominal computed tomography may aid in diagnosis. Treatment consists of eliminating the hernia defect by suture ligation and division of the falciform and ligamentum teres as well as surgical management of secondary bowel ischemia if present. The existence of 'parafalciform hernia' and 'bowel stringing falciform obstruction' must also be recognized as possible etiologies for visceral obstruction or strangulation caused by the falciform ligament.