A Defect of the Falciform Ligament Hernia Related to Previous Laparoscopic Surgery and Peritoneal Dialysis

A defect of the falciform ligament hernia is a rare type of internal hernia. We herein present a case of a falciform ligament hernia associated with previous laparoscopic cholecystectomy and recent introduction of peritoneal dialysis. A 76-year-old man presented with abdominal fullness and nausea 8 days after the introduction of peritoneal dialysis. He had a history of laparoscopic cholecystectomy 10 years previously. Exploratory films showed small bowel dilation; therefore, we conducted decompression therapy with a long tube. A follow-up CT scan showed a closed loop sign on the left side of the falciform ligament visible as a linear density, which was outlined by a dilated small intestine. Under the diagnosis of a defect of the falciform ligament hernia, laparotomy was performed. During laparotomy, a 40-cm small intestinal loop was incarcerated through a thumb-sized defect of the falciform ligament. He underwent an incision of the defect and small intestinal resection. He stayed in the intensive care unit for 3 days, then gradually recovered and was discharged. Early surgical intervention is recommended for such cases. The recognition of the falciform ligament outlined by a dilated small intestine is considered to be the key to making an accurate diagnosis.