Ligamentum falciforme separates liver from the left lateral and medial segments along the umbilical fissure and suspends the liveron the anterior wall of the abdomen. The ligamentum teres hepatis is a remnant of the obliterated umbilical vein, which lies on thefree edge of the falciform ligament. Moreover, it contains paraumbilical venules, muscle fibers, various fatty tissue amounts, andtwo mesothelial layers. Pathologies of the falciform ligament are considerably rare. The ligament is usually secondarily affected bysurrounding inflammatory diseases. Because of its rarity, necrosis, or abscess of the falciform ligament is usually misdiagnosed as anabdominal wall abscess, and inappropriate treatment leads to the lesion’s persistence and complications. Surgical resection is thetherapy of choice. The main purpose is to remind that respiratory problems can be the primary complaint of the patient who appliesto the emergency room with falciform necrosis secondary to acute pancreatitis.