Idiopathic primary omental infarction as a cause of acute abdomen

Infarto omental primario idiopático como causa de abdomen agudo

Introduction: idiopathic primary omental infarction is a rare cause of acute abdomen, with symptoms resembling those of acute appendicitis. Case report: 12-year-old female patient who presented with acute, intermittent, moderate to severe abdominal pain. Upon examination, abdomen was soft, depressible, with rebound tenderness on deep palpation in the right lower quadrant. Abdominopelvic computed tomography imaging showed a fat density tumor with small vessels, inflammatory changes within the omentum in the right upper quadrant and scant amount of fluid around the greater omentum. With the diagnostic possibility of focal omental infarction, it was managed conservatively with analgesia and anti-inflammatory medication. Discussion: due to its infrequent and non-specific presentation, it mimics other pathologies. It is rarely considered among the differential diagnoses of acute right-sided abdominal pain during childhood. Conservative treatment and surgery are the only therapeutic options, although there is no consensus regarding their effectiveness. Conclusion: idiopathic primary omental infarction should be considered in patients with acute abdominal pain. When diagnosed in the initial phase, the patient can be treated conservatively. Surgical intervention is indicated when conservative treatment fails, or complications arise.