Primary Omental Torsion Is a Diagnostic Challenge in Acute Abdomen—a Case Report and Literature Review

Abstract

Torsion of greater omentum is a rare cause of acute abdominal pain. It can be primary or secondary. Secondary omental torsions are associated with a number of preexisting conditions like inguinal hernia (most common), tumours, cysts, internal or external herniation, foci of intra-abdominal inflammation and postsurgical wound or scarring. Torsion of omentum causes twisting along its long axis resulting in impaired blood supply. This condition is rare and predominant in males. Most patients are middleaged adults. It clinically mimics acute appendicitis. If evaluated properly and diagnosed in time, good results can be achieved. We are presenting herewith a case of primary greater omental torsion and review of available literature.

Primary Omental Torsion: Case Report

“…BT'nin avantajı, karın ön duvarı ile kolon arasında olan kitlenin lokalizasyonunu tanımlama-sıdır. 2,4 Olgumuzda USG bulguları normal bulunmuş ve tanı BT ile konulmuştur.…”

Primary Omental Torsion in an Adolescent Male: Case Report

“…2 Similar with the presented case, the distal tip of the omentum is mobile in POT and there is no concomitant pathology. 6 Secondary omental torsion is more frequent than POT and is most commonly associated with groin hernia. Furthermore, tumors, cysts and foci of intra-abdominal inflammation may accompany secondary omental torsion.…”

“…Furthermore, tumors, cysts and foci of intra-abdominal inflammation may accompany secondary omental torsion. 1,6 The pain in omental torsion has a sudden onset and its localization depends on the extent and portion of omentum involved in torsion. 2 Usually the tip of right side of omentum twists thus patients suffer from a colic pain on the right lower quadrant of the abdomen as presented in our patient.…”

Acute abdomen caused by greater omentum torsion: a case report and review of the literature

“…[14] Adams, [12] and Barcia and Nelson [15] emphasized the association between right inguinal hernia and secondary omental torsion. …”

“…[16] As the torsion progresses, arterial occlusion leads to acute hemorrhagic infarction, and eventually to necrosis of the omentum. [14] Spontaneous reduction of omental torsion has sporadically been reported. [17] In a large majority of reported cases, omental torsion with infarction was segmental, involving the right side of the omentum, as it is longer, heavier, and more mobile than the left side.…”