OMENTAL INFARCTION: SURGICAL or CONSERVATIVE TREATMENT? A CASE REPORTS and CASE SERIES SYSTEMATIC REVIEW

Medina-Gallardo, N.A.; Curbelo-Peña, Yuhamy; Stickar, Tomás; Gardenyes, Júlia; Fernández-Planas, S.; Roura-Poch, Pere; Vallverdú, Helena

doi:10.1016/j.amsu.2020.06.031

Cited by 28 publications

(62 citation statements)

References 21 publications

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“…However, the failure rate of conservative treatment is reportedly 15.9% and complications include unresolved pain, abscess formation and adhesions. Additionally, patients in whom conservative treatment failed and laparoscopic surgery was performed were more likely to require open surgery (27.2%), which was not observed in the surgically treated group [ 7 ]. Laparoscopy is a useful surgical strategy [ 8 , 9 ] because precise diagnoses can be made by directly examining the abdominal cavity from a small incision.…”

Section: Discussionmentioning

confidence: 99%

Primary omental torsion diagnosed and treated laparoscopically: a case report

Imanishi

Iga

Mizuno

et al. 2021

Journal of Surgical Case Reports

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Omental torsion, a rare cause of acute abdomen in children and adults, is difficult to correctly diagnose before surgery because it mimics the common causes of acute surgical abdomen. We present a case of greater omental torsion that was diagnosed by laparoscopy. A 37-year-old man presented with right lower abdominal pain and was suspected to have appendicitis. Blood tests revealed elevated C-reactive protein and white blood cell count, whereas computed tomography revealed a nodular mass and high-density lesions in the fat tissue. As the patient’s abdominal symptoms were severe and a clear diagnosis could not be made, we performed exploratory laparoscopy. Laparoscopy revealed omental torsion, and an omentectomy was performed. The patient’s pain had significantly reduced post-surgery, and post-operative recovery was uneventful. Thus, laparoscopic examination is useful for accurately diagnosing omental torsion and is less invasive than surgery.

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Section: Discussionmentioning

confidence: 99%

Primary omental torsion diagnosed and treated laparoscopically: a case report

Imanishi

Iga

Mizuno

et al. 2021

Journal of Surgical Case Reports

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“…Approximately 300 cases have been reported with infarction of the greater omentum [ 1 , 2 ]. Approximately 85% of these cases are in adults aged 40 to 50 years, with a ratio of females to males greater than 2: 1 [ 1 , 2 , 4 ]. Infarction of the omentum is classified into 2 main types: primary and secondary infarction.…”

Section: Discussionmentioning

confidence: 99%

“…Omental infarction is a rare condition in emergency surgery. Bush described the first case in 1896 [ 1 , 2 ]. Since then, between 250 and 400 cases have been reported [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Surgery for Diagnosis and Treatment of Acute Right Upper-Quadrant Abdominal Pain Due to Omental Infarction: A Report of a Rare Case in a Single Vietnamese Hospital

et al. 2021

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Case series Patients: Female, 56-year-old • Female, 58-year-old Final Diagnosis: Omental infarction • omental torsion Symptoms: Abdominal and/or epigastric pain • nausea • right upper quadrant pain • vomiting Medication: — Clinical Procedure: Laparoscopic ometectomy • omentectomy Specialty: Surgery Objective: Rare disease Background: Omental infarction (OI) is an infrequent cause of acute abdominal pain, and there is no consensus on whether conservative or surgical treatment should be performed. The clinical manifestations are nonspecific, so many patients are referred for surgery because of acute abdominal signs that may indicate other diseases such as cholecystitis, appendicitis, or peptic ulcer perforation. In most cases, infarction of the greater omentum is diagnosed only during emergency surgery for other diseases of the abdomen. Currently, multisequence computed tomography is performed for acute abdomen, and this disease is increasingly diagnosed preoperatively. Case Reports: We report on 2 patients who were referred to our Emergency Department for acute abdominal pain. Both were female and middle-aged. The first patient presented with vomiting and right upper-quadrant pain with thickened and right subcostal omental infiltration on computed tomography (CT). The second patient presented with right subcostal pain and fever. CT showed signs of infiltration, thickening of the omentum, and a right upper subcostal mass measuring 22×60 mm. We performed emergency laparoscopic surgery to explore the abdominal cavity. Both patients were discharged after 3 days. Conclusions: Omentum infarction is a rare disease that causes a diagnostic dilemma, as there is a wide spectrum of causes of acute abdomen. Many patients are diagnosed only during surgery. Laparoscopic surgery should be performed as soon as possible.

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“…The OI is either the primary torsion defined as the idiopathic torsion of the vascular pedicle of the omentum, or the secondary torsion in which the torsion occurs secondary to a preexisting abdominal pathology such as the cysts, tumors, adhesions, hernia, or trauma. The treatment of OI could be conservative or surgical resection of infarcted omentum based on the patient's clinical, laboratory, and radiological findings progress 1,2 …”

Section: Case Descriptionmentioning

confidence: 99%