Primary Omental Infarction: Laparoscopic Approach in Two Pediatric Cases: A Case Review

Abstract

Two cases of pediatric acute abdomen owing to omental infarction are described in this paper, which were successfully treated laparoscopically. Owing to the objective rareness and absence of typical symptoms, the diagnosis was often neither made nor considered preoperatively. For other emergency situations, laparoscopy has been shown to be both a diagnostic and a therapeutic tool of a rare pathology found also in the pediatric patients.

Omental Infarction: Case Series and Review of the Literature

“…In addition, conservative treatment with analgesics and anti-inflammatory drugs is usually recommended for omental infarction because this disease runs a self-limited course (1,2,4,15,16). However, physicians should be alert to a rare occurrence of persistent pain or complications such as intestinal obstruction, abscess formation, and adhesion during conservative treatment (4,7). Surgical treatment can result in rapid amelioration of pain and prevent complications such as bleeding, adhesion, and abscess (6,7,11,28).…”

“…However, physicians should be alert to a rare occurrence of persistent pain or complications such as intestinal obstruction, abscess formation, and adhesion during conservative treatment (4,7). Surgical treatment can result in rapid amelioration of pain and prevent complications such as bleeding, adhesion, and abscess (6,7,11,28). In cases where the infarcted omentum adheres to the surrounding area of the ascending colon, the infarcted lesion is difficult to detect and remove through the standard McBurney incision, so diagnostic and therapeutic approaches using laparoscopy are recommended (1,7,28,34).…”

Caso Clinico Radiologico Para Diagnostico

“…La etiología del infarto omental primario o idiopático es desconocida; se han planteado al menos 2 hipótesis: una postula que existe una variante embriológica en la disposición de los vasos sanguíneos hacia el omento, que lo hace más susceptible CASO RADIOLOGICO PARA DIAGNOSTICO a torsión e infarto y la otra plantea que las venas omentales se vuelven más tortuosas, por aumento de la presión intraabdominal o por congestión vascular posterior a grandes ingestas alimentarias, lo que facilitaría el infarto (5,7) .…”

“…Respecto del manejo del infarto segmentario del omento mayor, la mayoría de la literatura radiológica lo describe como un cuadro benigno, autolimitado y susceptible de manejo conservador (1,9) . Algunas publicaciones recientes recomiendan cirugía laparoscópica, que permitiría disminuir la duración del dolor y posibles complicaciones, como abscedación del infarto (7,10) .…”

Pediatric case of acute right-sided abdominal pain: diagnosis is not always appendicitis

“…Omental infarction (OI) is an uncommon cause of acute abdominal pain occurring in ~0.1% of children who undergo laparotomy for suspected appendicitis. 1 , 3 , 4 It can cause acute abdominal pain in several different locations. 5 Multiple etiological factors have been associated with OI.…”