Omental Torsion and Infarction: CT Appearance

Abstract

P i c t u r e 1 . CT s c a n wi t h i n t r a v e n o u s c o n t r a s t s h o we d a ma s s i n t h e a n t e r i o r p o r t i o n o f t h e r i g h t l o we r q u a d r a n t e x t e n d i n g a l o n g t h e l a t e r a l c o l o n wa l l wi t h f a t d e n s i t y s h o wi n g s t r e a k s i n a wh i r l i n g p a t t e r n . PICTURES IN CLINICAL

Primary Greater Omental Torsion: Pre-operative CT and Intraoperative Findings Correlation

“…A basic advantage of CT versus sonography is the reliability of identifying the mass in the characteristic location between the anterior abdominal wall and the colon [14]. Specific CT findings in omental torsion include diffuse inflamed omental mass with whirling pattern fatty folds and vessels [15]. In our case, though, CT demonstrates the twisted omental part but ultrasound scan was not specific.…”

“…Imaging investigations such as ultrasonography and Computed Tomography (CT) have been suggested in the literature [12]. On sonography a complex mass consisting of hypoechoic and solid zones may be identified, but this imaging technique is operator dependent with limited sensitivity due to overlying bowel gas [13].…”

Omental torsion: a diagnostic challenge

“…2 Imaging investigations such as ultrasonography and CT have been suggested in literature. 12 On ultrasonography, a complex mass consisting of hypoechoic and solid zones may be identified, but this imaging technique is operator dependent with limited sensitivity due to overlying bowel gas. On CT, omental torsion is characterised by diffuse streaking in a whirling pattern of fibrous and fatty folds.…”

“…On CT, omental torsion is characterised by diffuse streaking in a whirling pattern of fibrous and fatty folds. 2,12 The whirling pattern may not be apparent in cases where the axis of rotation is not perpendicular to the transverse scanning plane. With increased use of CT, pre-operative diagnosis of omental torsion may increase in frequency and lead to conservative management in patients without complications.…”

“…With increased use of CT, pre-operative diagnosis of omental torsion may increase in frequency and lead to conservative management in patients without complications. 10,[12][13][14] The current investigation tool and therapeutic management of choice is laparoscopy proceeding to laparotomy, identifying and removing the infarcted section of omentum. Normal appendix, gallbladder and pelvic cavity make the diagnosis of omental torsion likely.…”