Left-sided omental infarction: a rare cause of abdominal pain, discovered by CT scan

Nijkamp, Jamie L G; Stassen, Patricia M.

doi:10.1136/bcr-2017-224138

Cited by 8 publications

(7 citation statements)

References 19 publications

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“…The vast majority of cases are treated conservatively, and this is why radiologists and clinicians must be aware of this condition in order to avoid unnecessary surgeries. The rich omental vascularity allows for quick anastomoses resolving the ischemia in most cases [ [7] , [8] ]. Surgical treatment is recommended when radiological findings are nonspecific and there are persistent symptoms.…”

Section: Discussionmentioning

confidence: 99%

Rare cause of postoperative acute abdominal pain: Giant omental infarct later complicated by colonic fistulization

Machado

Machado²,

Babu

2022

Radiology Case Reports

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Omental infarction is caused by vascular obstruction with resulting tissue ischemia, representing a rare cause of abdominal pain. It has been described as a rare complication of gastric bypass. It is important to recognize omental infarction and its possible complications as The management is usually conservative with surgery deferred to specific cases. We present the case of a 56-year-old male with a history of gastric adenocarcinoma who underwent esophagogastrectomy with Roux-n-y reconstruction and 3 months later presented with severe persistent abdominal pain, due to a path proven giant omental infarction. Patient later was complicated with a colonic fistula to the omentum.

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Section: Discussionmentioning

confidence: 99%

Rare cause of postoperative acute abdominal pain: Giant omental infarct later complicated by colonic fistulization

Machado

Machado²,

Babu

2022

Radiology Case Reports

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“…In most cases, there is an increase in the number of WBCs and CRP. The pain caused by omental infarction is nonspecific, so it is difficult to distinguish from other surgical diseases, such as cholecystitis, appendicitis, and diverticulitis [ 5 – 7 , 9 ]. The 2 patients underwent laparos-copy due to severe abdominal pain in the right upper quadrant.…”

Section: Discussionmentioning

confidence: 99%

“…According to the literature, omental infarction can be treated early by internal medicine (antibiotics, painkillers, anti-inflammatories) and assessment of abdominal signs on follow-up. The patient should be referred to surgery only if the clinical conditions worsen [ 7 – 9 ]. We present 2 patients with infarction of the greater omentum, which was treated by laparoscopic omentectomy.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Surgery for Diagnosis and Treatment of Acute Right Upper-Quadrant Abdominal Pain Due to Omental Infarction: A Report of a Rare Case in a Single Vietnamese Hospital

et al. 2021

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Case series Patients: Female, 56-year-old • Female, 58-year-old Final Diagnosis: Omental infarction • omental torsion Symptoms: Abdominal and/or epigastric pain • nausea • right upper quadrant pain • vomiting Medication: — Clinical Procedure: Laparoscopic ometectomy • omentectomy Specialty: Surgery Objective: Rare disease Background: Omental infarction (OI) is an infrequent cause of acute abdominal pain, and there is no consensus on whether conservative or surgical treatment should be performed. The clinical manifestations are nonspecific, so many patients are referred for surgery because of acute abdominal signs that may indicate other diseases such as cholecystitis, appendicitis, or peptic ulcer perforation. In most cases, infarction of the greater omentum is diagnosed only during emergency surgery for other diseases of the abdomen. Currently, multisequence computed tomography is performed for acute abdomen, and this disease is increasingly diagnosed preoperatively. Case Reports: We report on 2 patients who were referred to our Emergency Department for acute abdominal pain. Both were female and middle-aged. The first patient presented with vomiting and right upper-quadrant pain with thickened and right subcostal omental infiltration on computed tomography (CT). The second patient presented with right subcostal pain and fever. CT showed signs of infiltration, thickening of the omentum, and a right upper subcostal mass measuring 22×60 mm. We performed emergency laparoscopic surgery to explore the abdominal cavity. Both patients were discharged after 3 days. Conclusions: Omentum infarction is a rare disease that causes a diagnostic dilemma, as there is a wide spectrum of causes of acute abdomen. Many patients are diagnosed only during surgery. Laparoscopic surgery should be performed as soon as possible.

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“…Arguments in favor of surgical intervention are a shorter length of hospitalization time compared with conservative treatment, which save money. In addition, (laparoscopic) treatment is favored by some because it allows for confirmation of the radiologic findings [23].…”

Section: Discussionmentioning

confidence: 99%

Left-sided omental infarction without torsion: report of a case with radiologic-pathologic correlation

Corvino

Campanino

Rosa

et al. 2020

Egypt J Radiol Nucl Med

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Background Omental infarction is a rare disease that affects the entire omentum or a segment of the greater omentum. It presents as acute abdominal pain mainly in the right lower quadrant or right flank. Left-sided omental torsion is infrequent and it is rarely preoperatively diagnosed. Omental infarction is a differential diagnosis in the acute abdomen. As most cases of omental infarction can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention. Case presentation We herein report a case of a surgically proved left-sided infarction of the greater omentum presenting with abdominal pain, tenderness of the left flank. Specifically, we describe the ultrasound (US) and computed tomography (CT) findings of this rare disease providing a radiological-pathological correlation of them. To date, there are few similar correlation reports in literature. Conclusions Although the classical treatment of omental infarction is surgery, more recently the conservative management has been suggested. Thus, we believe that the knowledge of the characteristic imaging findings is essential for establish a correct preoperative diagnosis, which can avoid unnecessary surgical intervention.

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Left-sided omental infarction: a rare cause of abdominal pain, discovered by CT scan

Cited by 8 publications

References 19 publications

Rare cause of postoperative acute abdominal pain: Giant omental infarct later complicated by colonic fistulization

Rare cause of postoperative acute abdominal pain: Giant omental infarct later complicated by colonic fistulization

Laparoscopic Surgery for Diagnosis and Treatment of Acute Right Upper-Quadrant Abdominal Pain Due to Omental Infarction: A Report of a Rare Case in a Single Vietnamese Hospital

Left-sided omental infarction without torsion: report of a case with radiologic-pathologic correlation

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