Utilization of Imaging to Identify a Benign Condition Mimicking Acute Appendicitis in a Child

Phalke, Neelam; Mehta, Zubin; Das, Samrat U

doi:10.1177/2324709618797989

Cited by 6 publications

(9 citation statements)

References 21 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…US is a quick, safe, inexpensive and widely available diagnostic method to evaluate the presence of omental infarction. Our series suggests that US may be an accurate modality for a non-invasive pre-operative differential diagnosis between inflammatory conditions (as appendicitis) and omental infarction (Fragoso et al 2006;Estevão-Costa et al 2014;Lindley and Peyser 2018;Phalke et al 2018). Even though not immediately visible (it must be searched for), the presence of the "tethered fat sign" appears highly suggestive of omental infarction.…”

Section: Resultsmentioning

confidence: 86%

“Tethered Fat Sign”: The Sonographic Sign of Omental Infarction

Esposito

Ferrara

Schillirò

et al. 2020

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

Our purpose is to describe the ultrasound sign for a correct non-invasive diagnosis of omental infarction in children. From January 2014 to December 2018, a total of 234 children (109 boys and 125 girls, age range 3À15 y) with acute right-sided abdominal pain, admitted to our hospital with a presumptive diagnosis of acute appendicitis, were prospectively evaluated. In all patients, abdominal ultrasound was performed, and the omental fat was always evaluated. In 228 patients, the omental fat resulted to be normal or hyperechogenic, never tethered, and they results affected by other causes of abdominal pain different from omental infarction (such as appendicitis, pancreatitis, urolithiasis and others). In the remaining 6 children, we found a hyperechoic mass between the anterior abdominal wall and the ascending or transverse colon in the right abdomen quadrant, suggesting the diagnosis of omental infarction. This subhepatic mass was always tethered to the abdominal wall, motionless during respiratory excursions. We named this finding the "tethered fat sign." The diagnosis was confirmed with laparoscopy in 4 children. The other 2 children were treated with conservative therapy. In these 2 patients, a sonographic follow-up was performed, showing a progressive reduction in size of the right-sided hyperechoic mass. In conclusion, our study suggests that the presence of the "tethered fat sign" may be an accurate sonographic sign for non-invasive diagnosis of omental infarction in children.

show abstract

Section: Resultsmentioning

confidence: 86%

“Tethered Fat Sign”: The Sonographic Sign of Omental Infarction

Esposito

Ferrara

Schillirò

et al. 2020

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…Today, OI is more frequently diagnosed, thanks to the development of imaging techniques, including ultrasound and computed tomography [2]. CT is considered the gold standard for the diagnosis of OI owing to its high specificity and sensitivity in detecting symptoms [4,14,15]. However, with regard to children, CT is not preferred due to exposure to ionizing radiation [14].…”

Section: Discussionmentioning

confidence: 99%

“…CT is considered the gold standard for the diagnosis of OI owing to its high specificity and sensitivity in detecting symptoms [4,14,15]. However, with regard to children, CT is not preferred due to exposure to ionizing radiation [14]. Abdominal ultrasound is the safest diagnostic method, with a sensitivity of 60-80%, and is also used to follow the patient for infarct resolution during conservative treatment [3].…”

Section: Discussionmentioning

confidence: 99%

Omental Infarction in a Child—Conservative Management as an Effective and Safe Strategy in Diagnosis and Treatment

Kozłowski

Piotrowska

Giżewska-Kacprzak

2021

IJERPH

View full text Add to dashboard Cite

Omental infarction (OI) is a rare disease occurring in children. Important risk factors include overweight and obesity. The clinical presentation is often non-specific, and the main symptom is acute abdominal pain. In addition, infarcted omentum may present with fever, anorexia, nausea, vomiting, diarrhea and dysuria. Due to the localisation of the pain, OI should be differentiated from acute appendicitis. The diagnosis of OI is sometimes made intraoperatively, during appendectomy for suspected acute appendicitis. Hence, it is important to state a correct preoperative diagnosis, which is commonly based on abdominal ultrasound and computed tomography. The treatment of OI is still inconclusive. Both conservative and surgical treatments are used. Both methods have their advantages and disadvantages. The decision of which treatment to follow should be multifactorial and include the patient’s clinical condition at the time of admission, the progression or regression of symptoms during hospitalization and laboratory and imaging findings. We present a clinical case of a 9-year-old overweight girl with OI, whose diagnosis was based on imaging diagnostics and enabled conservative treatment with no complications. The case we have described confirms that the conservative treatment is an effective and safe therapy.

show abstract

“…The narrow stalk and laxity of attachments of these structures may predispose to twisting. Infarction of the greater omentum has been reported in the pediatric population, more commonly so in obese children [3,4,5]. IFFI's may be found at the time of surgical exploration for abdominal pain of indeterminate nature and are commonly resected.…”

Section: Discussionmentioning

confidence: 99%

Fatty-falciform ligament appendage torsion (F-FLAT): Diagnosis and management in a pediatric patient

Horak

Mega

Tanton

et al. 2020

Radiology Case Reports

View full text Add to dashboard Cite

Fatty-falciform ligament appendage torsion (F-FLAT) is a rare condition manifested by torsion of the extraperiotoneal fat within the falciform ligament. It is similar to intraperitoneal focal fatty infarctions, including omental infarction and epiploic appendagitis. We report herein the first case of F-FLAT in a pediatric patient that failed conservative management. Ultrasound and CT scan facilitated prompt diagnosis of this rare finding and expedited a quick trial of conservative management. Despite conservative treatment, symptoms persisted for 4 weeks, but resolved after laparoscopic single-site surgical resection. In this report, we discuss the clinical features, key radiographic findings, and treatment options for this unique condition. This is only the third reported pediatric case of F-FLAT in the literature, and the first pediatric case to require surgical resection.

show abstract

Utilization of Imaging to Identify a Benign Condition Mimicking Acute Appendicitis in a Child

Cited by 6 publications

References 21 publications

“Tethered Fat Sign”: The Sonographic Sign of Omental Infarction

“Tethered Fat Sign”: The Sonographic Sign of Omental Infarction

Omental Infarction in a Child—Conservative Management as an Effective and Safe Strategy in Diagnosis and Treatment

Fatty-falciform ligament appendage torsion (F-FLAT): Diagnosis and management in a pediatric patient

Contact Info

Product

Resources

About