Omental infarct: CT imaging features

Singh, Ajay K.; Gervais, Debra A.; Lee, P.; Westra, Sjirk J.; Hahn, Peter F.; Novelline, Robert A.; Müeller, Peter R.

doi:10.1007/s00261-005-0251-6

Cited by 96 publications

(77 citation statements)

References 11 publications

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“…10 The higher ratio (1:224) found in our series is in accordance with more recent reviews; 11,12 this may reflect the increasing disease's recognition and/or incidence, the latter being related to the growing prevalence of childhood obesity, a predisposing risk factor in OI. 7,8,13 OI is no longer a surprisingly intra-operative finding. Although not decisive, clinical awareness is important for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Eight patients (4 males) with an age of 8.5 [6][7][8][9][10][11][12][13] years were treated at initial course of the disease (Table 1). All presented with right-sided abdominal pain accompanied by hyperthermia in two cases; their weight was positioned in percentile 90 .…”

Section: Resultsmentioning

confidence: 99%

“…1); two were diagnosed by CT scan after a negative US. These six patients were submitted to conservative treatment and discharged after 3 [2][3][4][5][6][7][8] days of hospital stay. Two cases were only recognized at surgery after an US presumptive of acute appendicitis.…”

Section: Resultsmentioning

confidence: 99%

“…[3][4][5][6][7][8] We surveyed our series of OI cases focusing on the outcome of conservative management.…”

Section: Introductionmentioning

confidence: 99%

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Omental Infarction: a Reappraisal of Conservative Management in Children

et al. 2014

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RESUMOIntrodução: A melhoria da acuidade diagnóstica do enfarte do omento resultou num incremento da atitude conservadora no seu tratamento. Com o objectivo de avaliar a eficácia e segurança da abordagem não-operatória, analisámos os casos de enfarte do omento tratados num hospital terciário. Material e Métodos: Incluímos os casos de enfarte do omento primários tratados entre 2004 e 2011. Os enfartes do omento diagnosticados por imagiologia foram submetidos a tratamento conservador que constou de analgésicos e antibioterapia intravenosa. Avaliámos os dados demográficos, apresentação clínica, dados laboratoriais, imagiologia e resultado. Resultados: Ocorreram nove casos de enfarte do omento. Oito pacientes (4 rapazes), com uma idade mediana de 8,5 anos, apresentaram-se na fase inicial da doença por dor abdominal à direita; a contagem leucocitária era normal ou ligeiramente elevada. Seis casos, diagnosticados por TC após ecografia suspeita de enfarte do omento em quatro, foram trados conservadoramente sem complicações, tendo alta ao terceiro dia (mediana). Dois doentes foram apenas diagnosticados durante a intervenção cirúrgica por suposta apendicite. O nono caso apresentou-se com uma obstrução intestinal devida a hérnia interna que foi resolvida por laparoscopia. Discussão: A imagiologia foi diagnóstica na maioria dos casos de enfarte do omento, permitindo a adoção de uma abordagem conservadora. O tratamento não-operatório foi eficaz e sem complicações em todos os doentes que se apresentaram na fase inicial da doença. Um doente apresentou-se com uma complicação grave que requereu intervenção cirúrgica. Conclusão: Na ausência de um tratamento consensual para o enfarte do omento, a abordagem não-operatória é uma alternativa não invasiva e eficaz, mas requer uma vigilância clínica ativa. Palavras-chave: Enfarte; Omento.ABSTRACT Introduction: Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution. Material and Methods: Primary omental infarction treated between 2004 and 2011 were reviewed. Cases recognized by imaging studies were submitted to conservative treatment that consisted of intravenous analgesics and antibiotics. Demographics, clinical presentation, laboratory findings, imaging diagnosis and outcome were analyzed.Results: There were 9 cases of omental infarction. Eight patients (4 males; median age, 8.5 years) presented at initial course of disease; all had right-sided abdominal pain and a normal or lightly increased leukocyte count. Six cases, diagnosed by CT scan after US suspicion in four, were managed conservatively, recovered uneventfully, and were discharged after a median hospital stay of 3 days. Two patients were only recognized at surgery. An additional case presented with intestinal obstruction due to an internal hernia and was successfully resolved by laparoscopy. Discussion: Imaging techniques were d...

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…[3][4][5][6][7][8] We surveyed our series of OI cases focusing on the outcome of conservative management.…”

Section: Introductionmentioning

confidence: 99%

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Omental Infarction: a Reappraisal of Conservative Management in Children

et al. 2014

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“…Divertikülitte heterojen yağlı kitlenin komşuluğunda tipik olarak divertikül ve duvar kalınlaşması gösteren barsak ansı izlenir. Bu sayede divertikülit kolaylıkla apendisitis epiploika'dan ayrılır [7]. Mezenterik yağlı dokunun nonspesifik inflamasyon ve fibrozisi olan skerozan mezenteritte tipik olarak BT incelemede ince barsak mezenterinde vasküler yapılarda itilmeye neden olmayan Şekil 1.…”

Section: Discussionunclassified

A Rare Cause of Acute Abdominal Pain: Primary Appendagitis Epiploica

Ergün¹,

Lakadamyalı²

2015

Ann Clin Anal Med

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ÖzetAkut karın ağrısına neden olan primer apendisitis epiploika, kolonun epiploik apendikslerinin kendi kendini sınırlayan benign inflamatuar hastalığıdır. Tedavisi konservatiftir ve klinik olarak akut apandisit ya da omental torsiyon gibi cerrahi tedavi gerektiren durumlara benzer. Ancak nadir olması nedeni ile genellikle akut abdominal ağrılı olgularda hem cerrah hem de radyolog tarafından göz ardı edilir. Ancak bu hastalığın bilgisayarlı tomografi (BT) bulguları karakteristik olup tanı koydurucudur. Bu nedenle gereksiz cerrahi girişimlerin önlenmesi açısından bu hastalığın farkında olunması ve teşhis için BT tetkikinin seçilmesi son derece önemlidir.Biz burada bilgisayarlı tomografi ile tanısı konan akut abdominal ağrıya neden olan primer apendisitis epiploika olgusunu sunduk. Anahtar KelimelerApendisitis Epiploika; Bilgisayarlı Tomografi; Akut Abdominal Ağrı AbstractPrimary appendagitis epiploica -one of the causes of acute abdominal pain -is a self-limited rare benign inflammatory condition involving the colonic epiploic appendages. Their therapy is conservative and clinically mimics other conditions requiring surgery such as acute appendicitis or omental torsion. However, being a quite rare condition is the reason they are usually neglected by both the surgeon and the radiologist. However the computed tomography (CT) findings are rather characteristic and pathognomonic. Thus, to consider CT as the diagnostic modality of choice is extremely important in order to diagnose the condition and to avoid unnecessary surgical interventions. This is a paper reporting an acute abdominal pain case of primary appendicitis epiploica diagnosed using computed tomography.

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Spontaneous omental infarction as a rare differential for right iliac fossa pain: A case report and review of the literature

Lee,

Le,

Mark

2024

Clinical Case Reports

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Key Clinical MessageOmental infarction is a rare cause of acute abdominal pain, often benign and self‐limiting. The significance of infarction lies in the fact that it can mimic other abdominal pathologies including appendicitis, cholecystitis, pancreatitis, or reflux disease. Diagnostic laparoscopy provides the definitive diagnosis of omental infarction, but it is invasive and limited due to resources. Computed tomography of the abdomen and pelvis has been considered the gold standard to diagnosing omental infarction when a non‐invasive diagnostic approach is required. Additionally, ultrasound can also be used alternatively for children. Currently, there is no consensus in the diagnosis and management of patients with imaging‐proven omental infarction. Spontaneous infarcted omentum must be considered by surgeons and radiologists as a rare cause of acute abdominal pain as patients can experience good outcomes with either conservative or operative approach. However, conservative management must only be considered in stable patients where alternative pathology is unlikely.image

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Omental infarct: CT imaging features

Abstract: There is a significant difference in the age distribution and CT findings in terms of size of the omental infarction between primary and secondary etiologies. On follow-up CT, secondary omental infarcts progressively shrank and developed a well-defined, hyperdense rim around a fatty core.

Cited by 96 publications

References 11 publications

Omental Infarction: a Reappraisal of Conservative Management in Children

Omental Infarction: a Reappraisal of Conservative Management in Children

A Rare Cause of Acute Abdominal Pain: Primary Appendagitis Epiploica

Spontaneous omental infarction as a rare differential for right iliac fossa pain: A case report and review of the literature

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