IDIOPATHIC PRIMARY OMENTAL INFARCTION AS A CAUSE OF AN ACUTE ABDOMEN
Infarto omental primario idiopático como causa de abdomen agudo
Article Sidebar
PDF (Español (España))
FLIP
Main Article Content
Abstract
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.
Keywords:
Downloads
Article Details
References
Mani VR, Razdan S, Orach T, Kalabin A, Patel R, Elsaadi A, Sullivan K, Gattorno F. Omental infarction with acute appendicitis in an overweight young female: A rare presentation. Case Rep Surg. 2019;2019:8053931. doi: 10.1155/2019/8053931.
Gupta R, Farhat W, Ammar H, Azzaza M, Lagha S, Cheikh YB, Mabrouk MB, Ali AB. Idiopathic segmental infarction of the omentum mimicking acute appendicitis: A case report. Int J Surg Case Rep. 2019;60:66-68. doi: 10.1016/j.ijscr.2019.03.050.
Buell KG, Burke-Smith A, Patel V, Watfah J. Omental infarction: the great impersonator. Cureus. 2017;9(12):e1940. doi: 10.7759/cureus.1940.
Amo Alonso R, de la Peña Cadenato J, Loza Vargas A, Santos Santamarta F, Sánchez-Ocaña Hernández R, Arenal Vera JJ. Infarction of the greater omentum. Case report. Rev Esp Enferm Dig. 2015;107(11):706-7. doi: 10.17235/reed.2015.3754/2015.
Hamchou M, Kothari M, Sahari B, Swid A, Al-Salem AH. Segmental omental infarction: a rare cause of acute abdominal pain in children. Surg Laparosc Endosc Percutan Tech. 2014;24(1):e38-40. doi: 10.1097/SLE.0b013e3182900e2a.
Lindley SI, Peyser PM. Idiopathic omental infarction: One for conservative or surgical management? J Surg Case Rep. 2018;2018(3):rjx095. doi: 10.1093/jscr/rjx095.
Esposito F, Ferrara D, Schillirò ML, Grillo A, Diplomatico M, Tomà P. "Tethered fat sign": The sonographic sign of omental infarction. Ultrasound Med Biol. 2020;46(5):1105-1110. doi: 10.1016/j.ultrasmedbio.2020.01.003.
Hussain K, Munir A, Wahla MS, Mian MA, Masood J. Laparoscopic management of primary segmental omental infarction mimicking acute appendicitis. J Coll Physicians Surg Pak. 2015;25 Suppl 2:S89-90. doi: 10.2015/JCPSP.S89S90.
Bianchi F, Leganés Villanueva C, Brun Lozano N, Goruppi I, Boronat Guerrero S. Epiploic appendagitis and omental infarction as rare causes of acute abdominal pain in children. Pediatr Rep. 2021;13(1):76-85. doi: 10.3390/pediatric13010010.
Pogorelić Z, Katić J, Gudelj K, Mrklić I, Vilović K, Perko Z. Unusual cause of acute abdomen in a child--torsion of greater omentum: report of two cases. Scott Med J. 2015;60(3):e1-4. doi: 10.1177/0036933015581129.
Diab J, Badiani S, Berney CR. Diagnosis and management of adult omental infarction: 10-year case series. World J Surg. 2021;45(6):1734-1741. doi: 10.1007/s00268-021-06043-1.
Mitrovic M, Velickovic D, Micev M, Sljukic V, Djuric P, Tadic B, Skrobic O, Djokic Kovac J. Encapsulated omental necrosis as an unexpected postoperative finding: A case report. Medicina (Kaunas). 2021;57(9):865. doi: 10.3390/medicina57090865.
Foula MS, Sharroufna M, Alshammasi ZH, Alothman OS, Almusailh BA, Hassan KA. Non-operative management of primary omental torsion, a case report and literature review. Clin Case Rep. 2021;9(7):e04474. doi: 10.1002/ccr3.4474.
Han Y, Shen HG, Lu JJ, Xue XF, Yuan B, Xi TY, Zhou J, Kuang YT, Zhi QM, Zhao H. Simultaneous idiopathic segmental infarction of the great omentum with spontaneous splenic rupture: a rare association. Int J Clin Exp Med. 2015;8(4):6315-8.
Castro BN, Amado A, Torre AP, Azevedo J, Graça S, Maciel J. Idiopathic left omental infarction. Autops Case Rep. 2019;10(1):e2019123. doi: 10.4322/acr.2019.123.