IDIOPATHIC PRIMARY OMENTAL INFARCTION AS A CAUSE OF AN 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 similar to acute appendicitis. We present a case of idiopathic primary omental infarction as a cause of acute abdomen.

CASE PRESENTATION: A 12-year-old female patient presented with acute, intermittent abdominal pain of moderate to severe intensity. Abdomen was soft, depressible with pain on deep palpation in the right lower quadrant. Abdominopelvic computed tomography showed fat density tumor with small vessels present and inflammatory changes within omentum in the right upper quadrant with small amount of fluid around. These findings suggested diagnostic possibility of focal omental infarction. The patient was managed conservatively with anti-inflammatory analgesics.

DISCUSSION: Because its rare and its nonspecific presentation mimics other pathologic causes, idiopathic primary omental infarction is rarely considered among differential diagnoses of acute right-sided abdominal pain during childhood. Conservative treatment and surgery are the only treatment options, but there is no consensus regarding their effectiveness.

CONCLUSION: Idiopathic primary omental infarction should be considered in patients with acute abdominal pain. Clinical diagnosis is difficult, and imaging studies are often necessary to establish the condition. When the condition can be diagnosed preoperatively, conservative management is possible and surgery should be performed when conservative management fails or when there are complications.

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