The falciform ligament is a sickle-shaped double fold of peritoneum that attaches the front of the liver to the anterior abdominal wall and the diaphragm. Its free lower edge contains the ligamentum teres hepatis, the remnant of the fetal left umbilical vein, which runs to the umbilicus.
| Origin | Anterior abdominal wall above the umbilicus and the underside of the diaphragm |
|---|---|
| Insertion | Anterior and superior surfaces of the liver |
Attaches the liver to the anterior abdominal wall and carries the ligamentum teres hepatis in its free edge
The falciform ligament is divided during open abdominal surgery to provide access to the hepatic surfaces. In laparoscopic surgery it is retracted to expose the left liver lobe. The round ligament within its free edge is occasionally catheterised for portal access in interventional radiology. Falciform ligament herniation or tearing produces acute epigastric pain that mimics appendicitis or mesenteric ischaemia. The ligament may be used as a protective wrap around hepaticojejunostomy anastomoses.
Tearing of the falciform ligament from blunt abdominal trauma producing epigastric pain and haemorrhage along the ligament, identified on CT as a blood-density linear structure at the midline anterior abdomen.
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