Omental infarction: report of three cases and review of the literature

Abstract

Omental Infarction, the end result of impaired perfusion to the greater omentum, is a rare entity (JBCM Puylaert, Radiology 1992;185:169-172). We recently encountered three patients in whom computed tomography (CT) showed the characteristic findings of omental infarction. The diagnosis was subsequently confirmed intraoperatively and pathologically in two of the cases. The third case showed partial resolution on follow-up computed tomography. All three cases are presented with a brief review of the literature.

Omental Infarction Triggered by Tight Pants

“…CT scan is the gold standard for confirming diagnosis and demonstrates a whirling mass with hyper-attenuated fatty tissue and a large, cake-like mass centered in the omentum (11). If the diagnosis is established with imaging studies, patients can be managed conservatively (12). A case series report on children with omental infarction proposed indications for surgery as follows: uncertain diagnosis, intractable relentless pain, and persistent peritoneal findings (13).…”

CT Findings of Primary Torsion of the Greater Omentum with Segmental Infarction: Case Report

“…The US examination shows a hyperechoic, localized, usually paraumbilical mass (8,9). CT demonstrates a heterogeneous fatty mass anterior to the colon; adherent to an inflamed parietal peritoneum and containing strands of soft tissue attenuation (8,9). The appearance of irregular shaped soft tissue lesions with infiltration of the greater omentum at the level of the mid and lower abdomen enables the radiologist to differentiate omental infarction from a mass of omental origin.…”

“…So CT and/or ultrasound (US) can be extremely helpful in establishing the diagnosis. The US examination shows a hyperechoic, localized, usually paraumbilical mass (8,9). CT demonstrates a heterogeneous fatty mass anterior to the colon; adherent to an inflamed parietal peritoneum and containing strands of soft tissue attenuation (8,9).…”

Isolated omental panniculitis: two case reports and review of literature

“…In several studies published IOI was defined as having benign, selflimiting and inflammatory course consisting of gradual retraction, fibrosis and complete resolution in 2 weeks. When this course was considered a conservative treatment with analgesic and anti-inflammatory drugs under close follow-up is recommended (26,27,28) but surgical treatment is preferred for a better pain control, rapid recovery, to prevent complications like spontaneous bleeding, adhesion or abscess (18,29). Only in one patient with diagnosis of IOP, preoperative diagnosis was established and low dose of corticosteroid was started and omental mass was regressed.…”