Omental infarction and anterior wall adhesion presenting as surgical abdomen in a pediatric patient

Abstract

Omental infarction is a rare cause of acute abdomen that can present in both the pediatric and adult populations causing adhesions or abscesses. Presentation may mimic appendicitis; however, ultrasonography may not be sufficient. We discuss the importance of CT imaging for the pre‐surgical diagnosis to avoid serious port‐site injuries.

Omental infarction in an overweight child: conservative treatment is a safe approach

“…While there is a prevailing belief that conservative care may be adequate in the majority of cases, it is important to note that a potential complication in the conservative management of OI is the emergence of an omental abscess, together with adhesions leading to intestinal obstruction and peritonitis 16 17. Surgical intervention may be deemed necessary, particularly in cases where the patient is of a younger age and has an elevated WBC count equal to or greater than 12 × 109/L.…”

“…These factors have been found to be indicative of a higher likelihood of conservative treatment being unsuccessful. The utilisation of CT imaging should be taken into consideration for the purpose of pre-surgical diagnosis in cases where US has proven unsuccessful in achieving a definitive diagnosis 16. Despite the fact that some surgeons advocate for conservative treatment, the majority believe that laparoscopic excision is the optimal procedure.…”

“…Following the surgical excision, there is a quick improvement in the child’s clinical manifestations, thereby reducing the likelihood of abscess formation or other potential problems, such as bowel obstruction resulting from adhesions 2 17. Additionally, surgical intervention has been shown to shorten hospital stays 16…”