The torsion may include part of the omentum or the entire length 6, 7. Torsion of the omentum is a benign selflimiting disorder, which is difficult to diagnose because the main symptoms are similar to those of other abdominal diseases. Case report acute abdomen due to primary omental torsion and infarction s. Primary omental torsion is less common than secondary torsion 11. Pdf acute abdomen due to primary omental torsion and. Eitel first described primary omental torsion in 1899.
Omental torsion, a rare cause of acute abdomen bmj case. It is a rare cause of acute abdomen which mimics other commoner diagnoses and is commonly found intraoperatively. A computed tomography of abdomen revealed findings suggestive of omental torsion. Case report open access omental whirl associated with bilateral inguinal hernia. Primary omental torsion as presentation of acute abdomen.
Generally, the preoperative diagnosis is challenging because of its nonspecific signs and symptoms, and therefore omental torsion. Most of the published cases had been diagnosed during operation via direct eye view. Torsion of a bifid omentum as a rare cause of acute. Omental torsion is an infrequent cause of acute abdomen and its symptoms are nonspecific, often presenting with pain at the right iliac fossa as the only symptom. Primary omental torsion presenting as hip pain and limp. Idiopathic segmental infarction of the omentuma rare. The more common secondary torsion is associated with adhesion of the free end of the greater omentum to a cyst, tumor, surgical scar, sac of a hernia or an inflammatory focus 12. Torsion of the omentum is a condition in which the organ twists on its long axis to such an extent that its vascularity is compromised. A child with the rare diagnosis of acute appendicitis and. We report a case of omental torsion in a 7yearold girl, who presented with right iliac fossa pain. Omental torsion was first described by eitel et al. Omental torsion can be divided into primary, without any intraabdominal pathology, or secondary torsion. We report a case of surgically and pathologically proven omental torsion that demonstrated the typical whirling appearance on computed tomography.
Omental infarction oi is a rare cause of acute abdomen. Anatomical malformations, such as a bifid or accessory omentum consisting of an abnormal embryological position of the right part of the omentum with secondary fragile vascularity and abnormal deposits of fat, are predisposed for omental torsion. We present a case of primary omental torsion in a young man and discuss contemporary methods in. Recently, we encountered a case of omental torsion diagnosed as omental infarction preoperatively. Omental torsion is a rare cause of acute abdomen and sometimes requires surgery. Torsion of greater omentum is a quite uncommon cause of acute abdomen. No identifiable cause but may be related to local omental anatomical variations that allow a movable segment of omentum to twist around the proximal fixed point 4. Omental torsion is an uncommon cause of acute abdomen, usually mimicking acute appendicitis. Torsion of the greater omentum is a highly uncommon cause of acute abdomen in adults and is extremely difficult to diagnose preoperatively. Eitel 2 first reported a case of omental torsion unassociated with a hernia. Torsion of the greater omentum as a rare cause of acute. Omental infarction, or omental torsion, is an acute vascular disorder which compromises tissue of the greater omentum the largest peritoneal fold in the abdomen.
Primary omental torsion occurs when the mobile thickened segment of the omentum rotates around a. A case report of omental torsion, which is a rare differential diagnosis of the acute abdomen. There are two types, omental torsion and epiploic appendagitis. A 65yearold female attended at emergency department complaining of abdominal pain in the. Abdominal computed tomography showed a whirling pattern of fatty streaks and vessels within the greater omentum, and surgery confirmed infarction of the omentum secondary to torsion. It is perhaps fitting that primary omental pathology is rare, yet metastatic invasion, omental cysts, omental torsion, and omental infarction have all been reported in the literature. When compared with appendicitis, torsion has an incidence of 0.
Omental torsion is a rare cause of acute abdominal pain. Omental torsion is primarily seen in the 3050year age group, with male predominance. In contrast to secondary torsion of the greater omentum, which occur with intraabdominal pathology like adhesions or tumors, primary omental torsion pot results from twisting of the. An 18yearold male presented to our emergency room with a chief complaint of lower abdominal pain since previous 2 days.
Abstractidiopathic segmental infarction of the omentum is a rare cause of acute severe abdominal pain. A 11yearold boy presented with symptoms and signs suggestive of appendicitis. The treatment of choice for omental torsion is surgical excision of the necrotized tissue, preferably done laparoscopically. Omental torsion is a rare cause of acute abdomen in. Intraoperative diagnosis and treatment by resection are the current management of. Torsion of the greater omentum is a rare cause of acute abdomen, often disguised as acute appendicitis, acute cholecystitis, epiploic appendagitis, and various other diseases.
Omental infarction, with or without torsion, is a rare cause of acute abdominal pain, which makes it a difficult and unusual diagnosis to make. Laparoscopic omentectomy for preoperative diagnosis of. The twisted portion of the omentum tends to be localized to a rightside segment, thereby giving rise to the sudden onset. Primary omental torsion international archives of integrated medicine. Secondary omental torsion as a rare cause of acute abdomen in a child and the advantages of laparoscopic approach. Greater omental torsion is difficult to diagnose preoperatively. He was initially treated with pain control and antibiotics. Omental torsion is a rare cause of acute abdominal pain, which can present in two ways. According to several studies, it is important that the correct preoperative diagnosis is made as omental torsion. During surgery, omental torsion was diagnosed and the involved omentum was resected. Omental torsion is a rare cause of acute abdomen that is quite difficult to diagnose preoperative ly. Omental torsion is a rare cause of omental infarction, and it has been reported that torsion occurs when a portion of the omentum twists upon itself, leading to vascular compromise 7. Secondary omental torsion is due to an acquired attachment following hernia repair, a surgical scar, tumours or perforated bowel.
The patient underwent an open appendicectomy, during which a normal appendix was identified and a diagnosis of omental torsion. S editor wang jl l editor roemmele a e editor zheng xm. Case report open access omental whirl associated with. Omental torsion is classified as primary torsion with no underlying structural abnormality, or secondary an adhesion, cyst, tumor, hernia, or a focal site of inflammation predisposing to torsion.
Acute abdomen due to primary omental torsion and infarction. It can be primary or secondary but in both cases omentum twists upon itself and causes omental. Laparoscopic omentectomy in primary torsion of the greater. Omental torsion ot is a condition in which a pedicle of the omental apron twists on its longer axis to such an extent that its vascularity is compromised. Intraperitoneal focal fat infarction is a rare cause of acute abdomen. However, a few cases have been reported in children, and the estimated incidence of torsion. Omental definition of omental by medical dictionary. Always think about omental torsion when the appendix looks normal. The condition may be associated with nausea, vomiting. Omental torsion is a rare cause of acute abdomen in children and adults who.
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