Omental Cyst Presenting as an Acute Abdomen in a Pediatric Patient: A Case Report

Abstract

Background: Omental cysts are the rarest forms of intra-abdominal cystic lesions. They are usually asymptomatic but can also present as acute abdomen. The presentation is confusing in some cases, which may result in mismanagement, added costs, and trouble for the patient. A pre-operative diagnosis is challenging, especially in resource-limited settings, and requires a high level of suspicion and a cautious approach during emergency exploratory laparotomy to avoid complications. Case Details: This is a 4 year old male child who presented with high grade fever, vomiting, and abdominal pain of 2 days duration. He was tachypneic, tachycardic, and had diffuse abdominal tenderness. Emergency laparotomy revealed a large cyst with hemorrhagic content. Complete removal of the cyst was done, and the patient was discharged after improvement on the third post-operative day. Conclusion: Omental cysts are rare in children and have varieties of presentations. Even though preoperative diagnosis is challenging, esspecially in resource-limited settings, clinicians should consider omental cysts in a child presenting with an acute abdomen. It is important for surgeons to consider omental cysts when carrying out emergency laparotomy for an unidentified abdominal condition.

Omental Cyst With Torsion: A Rare Culprit of Pediatric Acute Abdomen

“…Abdominal distension may accompany cyst enlargement, resulting in a palpable mass upon examination. Gastrointestinal symptoms such as nausea, vomiting, and alterations in bowel habits can arise, attributed to mechanical pressure on the gastrointestinal tract [ 6 , 7 ]. Notably, incidental findings through imaging studies underscore the importance of considering omental cysts in asymptomatic cases [ 3 ].…”

Toddler with giant omental cyst, profound anemia, and shock: case report and review of the literature

“…In association with the absence of specific symptoms, the rarity of omental cysts, especially giant cysts, may complicate diagnosis. Greater omental cysts may mimic ascites ( 1 , 7 , 19 , 22 , 40 ), ovarian cysts ( 26 , 27 , 29 , 42 ), acute abdomen ( 7 , 25 , 26 , 42 ), and anemia ( 5 , 6 ). Omental cysts should be considered as a diagnostic hypothesis in children with abdominal pain, with or without a mass ( 42 ).…”