A Case of Abscess of the Round Ligament of the Liver: Single-Port Laparoscopic Resection

Abstract

A 70-year-old woman presented to her family doctor with sudden upper abdominal pain. Blood tests showed an elevated inflammatory response, and she was referred to our hospital for consultation. Abdominal CT showed a 66-mm area of hyperintensity in the round ligament of the liver, and we diagnosed abscess of the round ligament of the liver. Percutaneous abscess drainage and antibiotic administration resulted in prompt resolution of symptoms and normalized the inflammatory response. One month after diagnosis, we performed single-port laparoscopic surgery. In this surgery, we placed a port in the right lower abdomen and resected the round ligament of the liver along with a 40-mm large abscess scar. The patient had severe periodontitis, and since the abscess culture revealed oral resident bacteria, we assumed that the infection represented transarterial infection of periodontal origin. Abscess of the round ligament of the liver is rare, and surgical resection is recommended for treatment. We safely conducted a less invasive single-port laparoscopic surgery for giant abscess of the ligament of the liver by performing the surgery after percutaneous drainage and antibiotic treatment.