Primary omental torsion as presentation of acute abdomen. Case report

Moreno, Fernando Mendoza; Gago, Maria del Rocio Diez; García, Diego Martín Córdova; Muñoz, Antonio Pedraza; Alonso, Manuel Díez; Fraguas, Fernando Noguerales; Vicent, Francisco Javier Granell

doi:10.17235/reed.2015.3850/2015

Cited by 2 publications

(4 citation statements)

References 10 publications

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“…Less than 350 cases have been reported since the description by Bush, of which only 26 were treated using laparoscopic omentectomy. Torsion of the greater omentum accounts for only 1.1% of all cases of acute abdominal pain in adults and children [6, 7]. Omental torsion is primarily seen in the 30–50-year age group, with male predominance [8].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic omentectomy in primary torsion of the greater omentum: report of a case

Kataoka¹,

Nitta²,

Ota³

et al. 2019

surg case rep

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Background Torsion of the greater omentum is a rare cause of acute abdominal pain in adults and children. It is very difficult to make a correct diagnosis of torsion clinically because it mimics other acute pathologies; however, the preoperative diagnosis can be easily confirmed with the use of computed tomography (CT). Herein, we report a case of laparoscopic omentectomy for primary torsion of the omentum, which was not improved by conservative treatment. Case presentation A 50-year-old Japanese man presented to our hospital with acute right lower quadrant abdominal pain of a few hours’ duration. Routine blood tests showed a white blood cell count of 8900/mm 3 , and the C-reactive protein (CRP) level was 8.13 mg/dl. Contrast-enhanced CT scan of the abdomen revealed twisting of the omentum with a local mass of fat density and fluid distributed in a whirling oval-shaped mass pattern at the right flank and iliac fossa. Therefore, the patient was admitted to our hospital based on a diagnosis of omental torsion. The patient was treated with conservative treatment with analgesics, anti-inflammatories, and antibiotics. Although his symptoms were ameliorated, his laboratory and radiological findings worsened. We performed laparoscopic omentectomy 6 days after admission. The resected omentum was 24 cm × 22 cm in size and was twisted and dark red in color, suggesting infarction. Histological analysis revealed that the specimen was ischemic and hemorrhagic omentum, accompanied by inflammatory infiltration. The patient’s postoperative course was uneventful, and he was discharged 9 days later. Conclusion This is a rare case of primary torsion of the greater omentum that was treated successfully with laparoscopic omentectomy. Considering the increase in surgical difficulty due to inflammation from prolonged torsion and the limited efficacy of conservative treatment, we conclude that surgical intervention is warranted as early as possible when torsion of the greater omentum is suspected.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic omentectomy in primary torsion of the greater omentum: report of a case

Kataoka¹,

Nitta²,

Ota³

et al. 2019

surg case rep

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“…Greater omental torsion presents an incidence of 0.0016–0.37% and is the cause of 1.1% of cases with abdominal pain [ 4 ]. It occurs due to twisting of a pedicle of the omentum along its long axis, which results to vascular compromise and, eventually, necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Location of the pain depends on the torsion site and is usually localized in the right lower quadrant. Gastrointestinal symptoms, such as anorexia, nausea or vomiting are absent in over 50% of the patients, as intestinal peristalsis is not affected [ 4 ]. Leucocytosis and elevated body temperature could also occur, as well as a palpable mass, depending of the size of the segment involved.…”

Section: Discussionmentioning

confidence: 99%

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Primary greater omental torsion as a cause of acute abdomen—a rare case report

Karanikas

Kofina

Ali

et al. 2018

Journal of Surgical Case Reports

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Greater omental torsion is a rare entity that can cause acute abdominal pain, may mimick other abdominal pathologies, and is difficult to be diagnosed preoperatively. We present a case of a male patient with greater omental torsion mimicking the symptoms of acute appendicitis. A 31-year-old male patient presented with right scrotal pain, initially treated by the urologists, however, 24 h later, he presented right lower quadrant pain, with characteristics of acute appendicitis. After finding in ischemic inflammatory mass on McBurney incision, an exploratory laparotomy was performed, revealing torsion of the greater omentum. Torsion of the greater omentum can be a cause of acute abdomen and could be misdiagnosed with acute appendicitis. Preoperative diagnosis is not easy and resection of the affected tissue is the preferred treatment of choice.

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Primary omental torsion as presentation of acute abdomen. Case report

Cited by 2 publications

References 10 publications

Laparoscopic omentectomy in primary torsion of the greater omentum: report of a case

Laparoscopic omentectomy in primary torsion of the greater omentum: report of a case

Primary greater omental torsion as a cause of acute abdomen—a rare case report

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