Omental Infarction: An Unusual Cause of Left-Sided Abdominal Pain

Walia, Ritu; Verma, Rishi; Copeland, Neil; Goubeaux, Derrick L.; Pabby, Sahil; Khan, Raheel

doi:10.14309/crj.2014.60

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…Both primary and secondary omental infarction, with or without torsion, result in venous stasis and thrombosis leading to congestion and edema, pathologically with hemorrhagic necrosis and extravasation of serosanguineous peritoneal fluid. In our patient, no obvious anatomic and pathologic reasons or precipitating factors for the omental infarction were found, so we were dealing with a case of omental infarction without torsion [10,11]. The great majority of cases of omental infarction reported in the literature were segmental involving the right side of the omentum with right lower quadrant or right para-umbilical pain mimicking perforated duodenal ulcer, acute appendicitis, acute cholecystitis, cecal diverticulitis or epiploic appendagitis [1,2].…”

Section: Discussionmentioning

confidence: 74%

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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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Section: Discussionmentioning

confidence: 74%

“…It is known that hematologic changes occur during pregnancy and the puerperium and that hypercoagulability leads to an increased risk of thromboembolic events. The exact mechanism leading to infarction in this case remains unclear [9][10][11].…”

Section: Discussionmentioning

confidence: 91%

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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“…Omental infarction is a rare cause of acute abdomen with reported incidence being less than 4 per 1000 cases of appendicitis [6]. It usually presents as right-sided abdominal pain although seldomly causing left-sided abdominal pain and even epigastric pain [7, 8]. The dominion of right-sided abdominal pain in omental infarction has been attributed to right segmental infarction as a result of the tenuous blood vessels in this part of the omentum as well as its longer size and higher mobility in comparison to the left side which subjects it to torsion [2, 6, 7, 9].…”

Section: Discussionmentioning

confidence: 99%

Omental Infarction with Acute Appendicitis in an Overweight Young Female: A Rare Presentation

Mani

Orach

Kalabin

et al. 2019

Case Reports in Surgery

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Omental infarction is an uncommon cause of acute abdomen but one that clinically mimics more serious and common causes of acute abdomen like appendicitis and cholecystitis. Historically, it was diagnosed only intraoperatively during surgery for presumed appendicitis or other causes of acute abdomen. But with the increase in the use of imaging, especially abdominal computed tomography (CT) scan in the work-up for acute abdomen, more cases of omental infarction are being diagnosed preoperatively. This has also led to the observation that omental infarction is a self-limiting condition which can be managed conservatively. Currently, conservative management and surgery are the only treatment options for omental infarction with no consensus as to the best treatment modality. Having a patient with both acute appendicitis and omental infarction simultaneously is extremely rare with only two reported cases in the literature thus far. Here, we present a 10-year-old obese female who presented to our hospital with acute abdomen and was found to have acute appendicitis and omental infarction. The patient underwent laparoscopic appendectomy and resection of the infarcted omentum and had uneventful recovery and was discharged on the second postoperative day. In this report, we present a review of current literature on omental infarction and highlight the importance of imaging especially abdominal CT scan in the nonoperative diagnosis and treatment of omental infarction.

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“…2 Most of the cases reported in literature presented with right sided abdominal pain. 3 Omental infarction, due to its lower incidence is often misdiagnosed as acute appendicitis, epiploic appendagitis, diverticulitis, acute cholecystitis, acute pancreatitis and other intra-abdominal pathology.…”

Section: Discussionmentioning

confidence: 99%

“…Acute idiopathic omental infarction presenting as left iliac fossa pain is extremely rare in the medical literature, with 3 cases reported previously in the literature as of our knowledge. 2 Here we report a case of omental infarction causing left sided pain in a middleaged lady with no comorbidities…”

Section: Introductionmentioning

confidence: 96%

Acute idiopathic omental infarction as an unusual cause of left iliac fossa pain: a case report

Cholakkal¹,

Nambiar²,

Sahadevan³

et al. 2018

Int Surg J

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Acute idiopathic omental infarction is an uncommon cause of abdominal pain. Only about 300 cases have been reported in the medical literature so far.15% of cases occur in the pediatric age group. Omental infarctions are common on the right side and present as right iliac fossa pain. Clinical presentation usually mimics acute appendicitis and leads to unnecessary surgical intervention in majority of the cases. Acute idiopathic omental infarction presenting as left iliac fossa pain has not been reported till now in medical literature. Controversy exist regarding the management of acute omental infarction. While a few authors recommend surgical resection of the infarcted omentum, most authors recommend conservative management. Here we report a case 36 years old lady with acute idiopathic omental infarction presenting as the left sided abdominal pain. Diagnosis was made on contrast enhanced CT imaging. She was managed conservatively with NSAIDs and antibiotics. She was discharged after 2 days of in hospital. She improved clinically on outpatient follow up at 1 week, 1 month and 6 months. In short, acute idiopathic omental infarction is an unusual cause of left iliac fossa pain. Patients may benefit from conservative management, once the diagnosis is confirmed based on imaging. Further studies are necessary to devise a correct guideline on surgical intervention and conservative management in omental infarction.

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Omental Infarction: An Unusual Cause of Left-Sided Abdominal Pain

Cited by 6 publications

References 8 publications

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

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

Omental Infarction with Acute Appendicitis in an Overweight Young Female: A Rare Presentation

Acute idiopathic omental infarction as an unusual cause of left iliac fossa pain: a case report

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