Not only fat: omental infarction and its mimics in children. Clinical and ultrasound findings: a pictorial review

Esposito, Francesco; Serafino, Marco Di; Mauro, Angela; Mercogliano, Carmela; Cocco, Chiara; Zenzeri, Letizia; Ferrara, Dolores; Iacobellis, Francesca; Evangelisti, Melania; Ziparo, Chiara; Nardo, Giovanni Di

doi:10.1007/s40477-020-00492-5

Cited by 11 publications

(16 citation statements)

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“…The OI is either the primary torsion defined as the idiopathic torsion of the vascular pedicle of the omentum, or the secondary torsion in which the torsion occurs secondary to a preexisting abdominal pathology such as the cysts, tumors, adhesions, hernia, or trauma. The treatment of OI could be conservative or surgical resection of infarcted omentum based on the patient's clinical, laboratory, and radiological findings progress 1,2 …”

Section: Case Descriptionmentioning

confidence: 99%

Primary omental torsion in a pediatric patient

Javidi

Niazkar

Jalili

et al. 2021

Clinical Case Reports

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Section: Case Descriptionmentioning

confidence: 99%

Primary omental torsion in a pediatric patient

Javidi

Niazkar

Jalili

et al. 2021

Clinical Case Reports

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“…Omental infarction (OI) is a rare cause of acute abdominal pain in children, occurring in approximately 0.1% to 0.5% of children undergoing surgery for suspected appendicitis [1][2][3]. It results from the torsion of the vessels supplying the greater omentum.…”

Section: Introductionmentioning

confidence: 99%

“…Predisposing factors include: malformations of the mesenteric pedicle, a sudden increase in intraabdominal pressure (including sudden changes in posture), coagulation disorders, hernias, tumors and adhesions [4,5]. More often, OI occurs on the right side of the omentum due to its greater length, mass and higher mobility than the left-sided omentum [3,6]. Continuous abdominal pain with increasing intensity is a typical symptom.…”

Section: Introductionmentioning

confidence: 99%

“…OI is diagnosed more frequently today thanks to advanced imaging techniques, including ultrasound and computed tomography (CT) [2]. Children constitute about 15% of all reported cases [3] of omental infarction, and cases in children up to the age of 4 are particularly rare [4]. This may be due to the relatively low amount of intra-abdominal fat and omentum mass at this age [4].…”

Section: Introductionmentioning

confidence: 99%

“…This may be due to the relatively low amount of intra-abdominal fat and omentum mass at this age [4]. Obesity is considered to be the most important risk factor for the development of OI [3]. That is why the increasing tendency for childhood obesity may have a large impact on the increase in the prevalence of OI in more recent publications [4].…”

Section: Introductionmentioning

confidence: 99%

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Omental Infarction in a Child—Conservative Management as an Effective and Safe Strategy in Diagnosis and Treatment

Kozłowski

Piotrowska

Giżewska-Kacprzak

2021

IJERPH

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Omental infarction (OI) is a rare disease occurring in children. Important risk factors include overweight and obesity. The clinical presentation is often non-specific, and the main symptom is acute abdominal pain. In addition, infarcted omentum may present with fever, anorexia, nausea, vomiting, diarrhea and dysuria. Due to the localisation of the pain, OI should be differentiated from acute appendicitis. The diagnosis of OI is sometimes made intraoperatively, during appendectomy for suspected acute appendicitis. Hence, it is important to state a correct preoperative diagnosis, which is commonly based on abdominal ultrasound and computed tomography. The treatment of OI is still inconclusive. Both conservative and surgical treatments are used. Both methods have their advantages and disadvantages. The decision of which treatment to follow should be multifactorial and include the patient’s clinical condition at the time of admission, the progression or regression of symptoms during hospitalization and laboratory and imaging findings. We present a clinical case of a 9-year-old overweight girl with OI, whose diagnosis was based on imaging diagnostics and enabled conservative treatment with no complications. The case we have described confirms that the conservative treatment is an effective and safe therapy.

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