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Omental infarction (OI) is an uncommon cause of acute abdominal pain. A high index of clinical suspicion is required for diagnosis of OI as the incidence is less than 1 %, presenting with abdominal pain. We report primary OI’s clinical and radiological profile from a single tertiary care hospital in India.

Introduction: Malignant peritoneal mesothelioma (MPM) is a rare cancer that is associated with asbestos exposure. The diagnosis can be difficult given the nonspecific nature of presenting symptoms and the presence of concomitant confounding findings. Case Presentation: We report a 71-year-old male who presented with right lower quadrant pain and new-onset ascites. CT imaging of the abdomen/pelvis demonstrated omental stranding concerning for a possible omental infarction. Subsequent imaging showed persistent omental edema but no identifiable soft tissue mass. A biopsy of the omentum showed atypical mesothelial proliferation, but pathology was unable to determine if proliferation was a neoplastic versus reactive process. Surgical oncology performed a diagnostic laparoscopy that showed peritoneal studding of the omentum. Subsequent immunohistochemical staining of the omentum demonstrated preservation of BAP1 expression and loss of MTAP expression, consistent with peritoneal mesothelioma. Conclusion: MPM is a rare and aggressive cancer with an overall poor prognosis. The diagnosis of MPM can be difficult based on the nonspecific clinical presentation, insufficient imaging and laboratory testing, and the presence of concomitant confounding findings, such as with this patient and his admitting diagnosis of omental infarction. This case demonstrates the importance of developing a broad differential while maintaining an awareness of heuristics that can influence clinical decision-making.

Background: Omental artery aneurysm (OAA) is an extremely rare visceral artery aneurysm. Ruptured OAAs are associated with a high mortality rate. Transcatheter arterial embolization (TAE) has been used to treat OAA in recent years. However, the risk of omental ischemia due to TAE remains unclear. Therefore, this study aimed to investigate the efficacy and safety of TAE of OAA as a first-line treatment. Methods: Fifteen patients with true aneurysms or pseudoaneurysms who underwent OAA-TAE between 1 April 2010 and 31 December 2022 were included in this study. The technical and clinical outcomes, the incidence of omental infarction after TAE as a major complication, OAA-TAE techniques, radiological findings on computed tomography angiography and angiogram, and patient characteristics were evaluated. Results: Fifteen patients (nine men, six women; age, 69.8 ± 18.59 years) underwent TAE of OAAs (mean aneurysm size of 9.30 ± 6.10 mm) located in the right gastroepiploic (n = 9), left gastroepiploic (n = 1), and epiploic (n = 5) arteries. All patients with ruptured (n = 6) and unruptured (n = 9) OAA successfully underwent TAEs using coils, n -butyl-2-cyanoacrylate, or gelatin sponges. Hepatic artery thrombosis and coil migration were observed during the procedure; however, these adverse events were manageable. Transfusion of red blood cell units (4.66 ± 1.63 units) was required only in cases with ruptured OAAs after TAE. Additional surgery or TAE due to rupture or rerupture of OAA and omental infarction was not required during the postoperative and follow-up periods. Conclusion: The OAA-TAE can effectively treat ruptured and unruptured OAAs, and the risk of omental infarction after OAA-TAE may not be high. [ABSTRACT FROM AUTHOR]

Partial infarction of the great omentum is a rare cause of abdominal pain and may present as a surgical emergency. Omental infarction might occur due to its torsion, but cases without obvious cause are reported. Risk factors related to this condition are overweight, obesity, abdominal trauma, recent abdominal surgery, hypercoagulability, postprandial vascular congestion and an increase in intra-abdominal pressure. Because of the condition's rarity, most patients are treated with surgery and the diagnosis is established intraoperatively. Preoperative diagnosis allows successful conservative treatment with analgesics and anti-inflammatory drugs. This case reports a young female patient with class III obesity presented with spontaneous partial infarction of the great omentum treated with laparoscopy. [ABSTRACT FROM AUTHOR]

Introduction: Malignant peritoneal mesothelioma (MPM) is a rare cancer that is associated with asbestos exposure. The diagnosis can be difficult given the nonspecific nature of presenting symptoms and the presence of concomitant confounding findings. Case Presentation: We report a 71-year-old male who presented with right lower quadrant pain and new-onset ascites. CT imaging of the abdomen/pelvis demonstrated omental stranding concerning for a possible omental infarction. Subsequent imaging showed persistent omental edema but no identifiable soft tissue mass. A biopsy of the omentum showed atypical mesothelial proliferation, but pathology was unable to determine if proliferation was a neoplastic versus reactive process. Surgical oncology performed a diagnostic laparoscopy that showed peritoneal studding of the omentum. Subsequent immunohistochemical staining of the omentum demonstrated preservation of BAP1 expression and loss of MTAP expression, consistent with peritoneal mesothelioma. Conclusion: MPM is a rare and aggressive cancer with an overall poor prognosis. The diagnosis of MPM can be difficult based on the nonspecific clinical presentation, insufficient imaging and laboratory testing, and the presence of concomitant confounding findings, such as with this patient and his admitting diagnosis of omental infarction. This case demonstrates the importance of developing a broad differential while maintaining an awareness of heuristics that can influence clinical decision-making. [ABSTRACT FROM AUTHOR]

Omental infarction is an uncommon cause of acute abdominal pain that can occur in different several locations. We report 2 cases of omental infarction diagnosed at computed tomography (CT) scan performed as part of routine oncological surveillance, one right-sided and the other left sided. This paper illustrates the range of CT scan findings and highlights the important clinical implications of this radiological diagnosis.

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Omental infarction (OI) is a rare condition with an overall incidence of less than 0.3%. It can occur spontaneously or can be secondary to trauma, surgery, and inflammation. While previously a diagnosis of exclusion, due to development in imaging technology, OI can now be identified based on CT findings. OI symptoms can mimic an acute abdomen, prompting potentially unnecessary surgical exploration. Treatment options range from conservative management to interventional radiology or surgical resection of the infarcted omentum. We are presenting the first case of OI following robotic-assisted inguinal hernia repair. This case highlights the importance of considering OI in differential diagnoses for patients presenting with acute abdominal pain, the utility of imaging workup in identifying OI, and guidance for conservative treatment approaches to reduce unnecessary surgical intervention. [ABSTRACT FROM AUTHOR]

Omental infarction (OI) is a rare cause of acute abdominal pain, which is benign and self-limited. It is diagnosed by imaging. The etiology of OI is either idiopathic or secondary and due to torsion, trauma, hypercoagulability, vasculitis, or pancreatitis. Here, we present a case of OI in a child with acute severe right upper quadrant pain. Correct diagnosis of OI via imaging can prevent unnecessary surgery. [ABSTRACT FROM AUTHOR]

Abstract Background Omental infarction is a rare disease that affects the entire omentum or a segment of the greater omentum. It presents as acute abdominal pain mainly in the right lower quadrant or right flank. Left-sided omental torsion is infrequent and it is rarely preoperatively diagnosed. Omental infarction is a differential diagnosis in the acute abdomen. As most cases of omental infarction can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention. Case presentation We herein report a case of a surgically proved left-sided infarction of the greater omentum presenting with abdominal pain, tenderness of the left flank. Specifically, we describe the ultrasound (US) and computed tomography (CT) findings of this rare disease providing a radiological-pathological correlation of them. To date, there are few similar correlation reports in literature. Conclusions Although the classical treatment of omental infarction is surgery, more recently the conservative management has been suggested. Thus, we believe that the knowledge of the characteristic imaging findings is essential for establish a correct preoperative diagnosis, which can avoid unnecessary surgical intervention.

Background: Idiopathic omental infarction (IOI) is challenging to diagnose due to its low incidence and vague symptoms. Its differential diagnosis also poses difficulties because it can mimic many intra-abdominal organ pathologies. Although hypercoagulability and thrombosis are among the causes of omental infarction, venous thromboembolism scanning is rarely performed as an etiological investigation., Case Summary: The medical records of the 5 cases, who had the diagnosis of IOI by computed tomography, were examined. The majority of the patients were male ( n = 4, 80%) and the mean age was 31 years (range: 21-38). The patients had no previous abdominal surgery or a history of any chronic disease. The main complaint of all patients was persistent abdominal pain. Omental infarction was detected in all patients with contrast-enhanced computed tomography. Conservative treatment was initially preferred in all patients, but it failed in 1 patient (20%). After discharge, all patients were referred to the hematology department for thrombophilia screening. Only 1 patient applied for thrombophilia screening and was homozygous for methylenetetrahydrofolate reductase (A1298C mutation) and heterozygous for a factor V Leiden mutation., Conclusion: IOI should be considered in the differential diagnosis in patients presenting with progressive and/or persistent right side abdominal pain. Investigating risk factors such as hypercoagulability in patients with IOI is also important in preventing future conditions related to venous thromboembolism., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Omental infarction is a rare but threatening cause of acute abdomen. The preoperative diagnosis is challenging due to its infrequent nature. It poses nonspecific abdominal signs that can be easily mistaken for other more common intra-abdominal pathologies. Here, we report a case of a 31-year-old female who presented with acute abdominal pain. A simple CT scan of the abdomen showed signs suggestive of an omental infarction. An exploratory laparotomy was performed with resection of the mass, and histopathology reports confirmed the diagnosis. The diagnosis of omental infarction is complicated and rarely made prior to surgery. Surgical treatment provides better results and prevents complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vázquez-Lara et al.)

Intraperitoneal focal fat infarction (IFFI) is a rare condition characterized by infarction of fatty tissue within the abdominal cavity. Lesser omental infarction, a relatively rare type of IFFI, occurs when there is an infarction of fat within the lesser omentum. Patients typically present with acute abdominal pain that can mimic more serious conditions. This case report highlights the clinical presentation, diagnostic challenges, and management strategies for patients presenting to the emergency department with lesser omental infarction. A 63-year-old female presented to the emergency department with a chief complaint of epigastric abdominal pain that had been persisting for approximately a week and a half. The pain, which initially seemed like a sore muscle, became increasingly sharp and intermittent, with tenderness upon palpation of the epigastric area. Computed tomography (CT) imaging revealed an omental infarct in the lesser sac with focal inflammation in the fat of the lesser omentum. Through conservative management with analgesics and anti-inflammatory medication, the patient experienced resolution of her symptoms within a few days and had a follow-up with the gastrointestinal team several weeks later. Lesser omental infarction typically results from compromised blood flow due to torsion or thrombosis, leading to ischemia and necrosis of the fatty tissue. CT imaging is crucial for its diagnosis and reveals fat-density lesions with surrounding inflammatory changes. Conservative management is typically effective, though in rare cases, surgical intervention may be necessary when significant vital signs and electrolyte derangements occur., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Mayo Clinic Institutional Review Board (IRB) issued approval 24-004634. All prospective clinical studies and research involving human subjects undertaken by our institution have received IRB/ethics committee approval as mandated. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Martini et al.)

Omental infarction is an uncommon cause of abdominal pain. The condition is often misdiagnosed due to its clinical similarity to more common abdominal pathologies like appendicitis and cholecystitis. This report presents the case of a 57-year-old female with a one-week history of left-sided abdominal pain, initially aggravated by eating and defecation. The patient, a long-term smoker with a complex medical history that includes deep vein thrombosis and pulmonary embolism, was hemodynamically stable on presentation. A CT scan revealed a nodular infiltration consistent with an omental infarct. Conservative management was pursued, resulting in symptom resolution by the third day of hospitalization. This case underscores the diagnostic challenges associated with omental infarction, particularly its differentiation from other causes of acute abdominal pain. It highlights the importance of considering rare etiologies in patients with atypical presentations and emphasizes the role of imaging, particularly CT scans, in accurate diagnosis. The patient's successful conservative management aligns with current recommendations, which advocate for non-surgical treatment in most cases. This approach avoids unnecessary surgical interventions and ensures a favorable prognosis with low complication rates in patients with prompt and appropriate management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Brito et al.)

Background: Omental infarction is a rare pediatric disease. Ultrasound is a useful modality for a non-invasive pre-operative differential diagnosis between inflammatory conditions (as appendicitis) and omental infarction, especially by detecting immobility of the omentum adhered to the abdominal wall ("tetherd fat sign"). However, this is a dynamic sign that cannot be documented in a static image with B-mode technique. The goal of this work is to incorporate the versatile function of motion mode (M-mode) into omental infarction diagnosis to describe how the M-mode is useful in the evaluation of fat motion in children suspected of having omental infarction. In 2019 we suggested a new Ultrasound sign named "tethered fat sign" for an accurate non-invasive diagnosis of omental infarction in children. This finding was observed in 6 of the 234 seen children of our previous study with 4 laparoscopic confirmed diagnosis., Methods: From January 2019 to July 2021, we evaluated 195 children (91 boys and 104 girls, from 3 to 15 years) admitted to our Santobono-Pausilipon Children Hospital with acute right-sided abdominal pain. Abdominal ultrasound was performed to all the patients and the investigation of "tethered fat sign" was always included., Results: In 7 patients ultrasound showed the presence of a hyperechoic oval mass localized in the right upper abdominal quadrant and in 2 of these M-mode documented a normal subhepatic fat moving during respiratory movements in relation with the abdominal wall. The remaining 5 patients had an omental infarction showed as a subhepatic motionless mass tethered to the abdominal wall on M-mode. In these patients, a sonographic follow-up was performed every 15 d for 2 months showing a progressive reduction in size of the right-sided hyperechoic mass., Conclusions: In the evaluation of all children who showed the presence of the "tethered fat sign" the use of M-mode provide a certified image in diagnostic ultrasound., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1691/coif). The authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Postsurgical fat necrosis is a frequent finding in abdominal cross-sectional imaging. Epiploic appendagitis and omental infarction are a result of torsion or vascular occlusion. Surgery or pancreatitis are conditions that can have a traumatic and ischemic effect on fatty tissue. The imaging appearances may raise concerns for recurrent malignancy, but percutaneous biopsy and diagnostic follow-up assist in the accurate diagnosis of omental infarction. Herein we describe a case of encapsulated omental necrosis temporally related to gastric surgery. Preoperative CT and MRI findings showed the characteristics of encapsulated, postcontrast nonviable tumefaction in the epigastrium without clear imaging features of malignancy. Due to the size of the lesion and the patient’s primary disease, tumor recurrence could not be completely ruled out, and the patient underwent surgery. Histopathological analysis confirmed the diagnosis of steatonecrosis of the omentum [ABSTRACT FROM AUTHOR]

Acute surgical abdomen is still forming a diagnostic dilemma in children. Omental torsion was an overlooked differential diagnosis in the era of open appendectomy, but nowadays with the propagation of laparoscopic surgery in pediatric age group there are more reports published describing the omental torsion.Clinical picture of Primary omental torsion is mimicking the diagnosis of acute appendicitis and for most of the cases the diagnosis will be only discovered intraoperatively. Primary omental torsion is more common on the right side of the greater omentum. Free peritoneal serosanguinous fluid is a common intraoperative finding.Due to increasing number of reported cases, omental torsion should always be ruled out in cases of negative laparoscopic exploration for acute abdomen in children. Here we are reporting three cases of omental torsion presented with right lower abdominal pain and primary omental torsion was found during laparoscopic exploration. Laparoscopic excision of the infarcted omentum was done. The clinical course, findings and treatment are highlighted. .

The term intraperitoneal focal fat infarction (IFFI) includes various self-limiting clinical conditions that are caused by focal fatty tissue necrosis. Most of the cases of IFFI concern torsion or infarction of the greater omentum or the epiploic appendages. However, although rarely, perigastric ligaments can also undergo torsion also leading to fat infarction. IFFI clinically may mimic other pathologies, such as acute appendicitis or diverticulitis, making their clinical diagnosis a challenge. Ultrasound (US) and computed tomography (CT) have a high sensitivity and specificity for the diagnosis of IFFI excluding other pathologies, and in most cases, the clinical evolution is spontaneously favorable, thus helping to reduce the need for unnecessary surgical intervention. We review cases with IFFI in order to identify specific involvement patterns. Cases of epiploic appendages reported to an acute, subacute, and more chronic phase in order to present the self-limiting nature of this entity and the resultant absorption. We also present cases with falciform ligament infarction, as well as primary ("whirl sign" on CT due to greater omentum torsion) and secondary omental infarctions. The aim of this pictorial review is not only to extensively explore the imaging findings of IFFI but to also describe the clinical presentation and pathophysiology of the prementioned conditions. [ABSTRACT FROM AUTHOR]

Acute abdominal pain in children is the most common cause of emergency department admissions. Omental infarction is a rare cause of acute abdominal pain in this age group, accounting for approximately 15% of cases in children and 0.024–0.1% of cases of surgery for suspected appendicitis at the same age. Its clinical presentation may mimic similar diseases such as acute appendicitis, epiploic appendagitis, and mesenteric panniculitis. Ultrasound is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients and it can be used with confidence in the diagnosis and management of omental infarction in children. In this brief review, we focus on the main ultrasound findings and their diagnostic clue for omental infarction and its mimics. [ABSTRACT FROM AUTHOR]

Background Omental infarction is a rare cause of acute pain abdomen and is difficult to diagnose clinically due to nonspecific clinical features. Multidetector computed tomography (MDCT) imaging of the abdomen is essential for the diagnosis of omental infarction and is also crucial to rule out appendicitis and other causes of acute pain abdomen. Objective The main purpose of this article is to describe the MDCT features of omental infarction in clinching the diagnosis and differentiating it from its clinical mimics. Methods CT findings of five patients with diagnosed omental infarction were retrospectively reviewed from 2014 to 2019. All patients presented with pain abdomen on the right side of the abdomen with various clinical diagnoses. MDCT was done for diagnosis and features evaluated include size of the lesion, location, relation to colon, and findings that were correlated to clinical presentation and etiology. Results Age distribution ranged between 36 and 55 years with female predominance. Out of five cases, one was secondary omental infarction due to inguinal hernia causing omental torsion and the other four cases were of unknown etiology. Three cases were managed conservatively and the other two cases were surgically managed. Three lesions were in right iliac fossa and two lesions were in the supraumbilical region on the right side. Conclusion Omental infarction should be considered important in the differential diagnosis of acute pain abdomen mimicking acute appendicitis and requires CT abdomen to establish diagnosis. Knowledge of typical imaging findings and application for diagnosis are important, as it is a self-limiting disease and can avoid unnecessary surgical interventions.

Omental infarction is a rare pathology which develops as a result of impairment of perfusion of the omentum magus, which can imitate almost all acute abdomen symptoms with its clinical findings. The patient who applied to our emergency department with the complaint of abdominal pain that has started three days ago was taken under operation with the prediagnosis of omental infarction as a result of the analyses conducted. In laparotomy, omentum torsioned along normal appendix and long axis and undergone necrosis was observed. Torsioned necrotic omentum tissue has been excised. Our conclusion from the case and literature is that omental torsion and idiopathic omental necrosis should be also considered in patients with abdominal pain complaint. [Med-Science 2019; 8(2.000): 454-6]

COVID-19 is an infection which can present with various clinical manifestations. While it affects respiratory tract primarily, several other manifestations including gastrointestinal involvements have been reported. The prevalence of all gastrointestinal complaints is approximately 17 percent and diarrhea, nausea/vomiting and abdominal pain are the most common symptoms. In COVID-19, acute abdominal pain requiring surgical evaluation and abdominal imaging is uncommon and there is also a lack of knowledge about COVID-19 related gastrointestinal complications. Here, we report a case of mild COVID-19 infection complicated by omental infarction during the course of the illness. [ABSTRACT FROM AUTHOR]

Omental infarction is a rare phenomenon that can be idiopathic or secondary to a surgical intervention. Greater omentum division has been advocated to decrease tension at the gastro-jejunal anastomosis during laparoscopic Roux-en-Y gastric bypass (RYGB). We report a case of omental infraction complicated by liquefied infected necrosis presenting 3 weeks after antecolic antegastric RYGB. The patient underwent laparotomy and subtotal omentectomy with a protracted hospital course due to intra-abdominal abscesses, acute kidney injury and small bowel obstruction that were successfully managed non-operatively. We reviewed the available literature on omental infarction after RYGB, focusing on associated symptoms, possible etiology, timing of presentation, management and propose an alternative technique without omental division. [ABSTRACT FROM AUTHOR]

Background: Omental infarction is a rare disease that affects the entire omentum or a segment of the greater omentum. It presents as acute abdominal pain mainly in the right lower quadrant or right flank. Left-sided omental torsion is infrequent and it is rarely preoperatively diagnosed. Omental infarction is a differential diagnosis in the acute abdomen. As most cases of omental infarction can be adequately diagnosed via computed tomography, a conservative treatment strategy for patients without complications should be considered in order to avoid any unnecessary surgical intervention. Case presentation: We herein report a case of a surgically proved left-sided infarction of the greater omentum presenting with abdominal pain, tenderness of the left flank. Specifically, we describe the ultrasound (US) and computed tomography (CT) findings of this rare disease providing a radiological-pathological correlation of them. To date, there are few similar correlation reports in literature. Conclusions: Although the classical treatment of omental infarction is surgery, more recently the conservative management has been suggested. Thus, we believe that the knowledge of the characteristic imaging findings is essential for establish a correct preoperative diagnosis, which can avoid unnecessary surgical intervention. [ABSTRACT FROM AUTHOR]

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 3-15 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. [ABSTRACT FROM AUTHOR]

Abstract Omental infarction although infrequent should be considered as a possible cause of acute abdomen precisely in those with negative appendectomy.

Postsurgical fat necrosis is a frequent finding in abdominal cross-sectional imaging. Epiploic appendagitis and omental infarction are a result of torsion or vascular occlusion. Surgery or pancreatitis are conditions that can have a traumatic and ischemic effect on fatty tissue. The imaging appearances may raise concerns for recurrent malignancy, but percutaneous biopsy and diagnostic follow-up assist in the accurate diagnosis of omental infarction. Herein we describe a case of encapsulated omental necrosis temporally related to gastric surgery. Preoperative CT and MRI findings showed the characteristics of encapsulated, postcontrast nonviable tumefaction in the epigastrium without clear imaging features of malignancy. Due to the size of the lesion and the patient’s primary disease, tumor recurrence could not be completely ruled out, and the patient underwent surgery. Histopathological analysis confirmed the diagnosis of steatonecrosis of the omentum.

Objective: Acute abdominal pain is a common complaint of patients in the emergency department that needs to be evaluated rapidly and comprehensively. With a wide range of etiologies, acute abdominal pain is still a major diagnostic challenge in the emergency department. Radiological imaging is the corner stone of the diagnostic work up along with clinical and laboratory findings. Case Report: In this case report, we present our 4 cases of acute abdominal pain caused by rare disorders (epiploic appendagitis, omental infarction, mesenteric panniculitis and cecal diverticulitis) that were initially diagnosed mistakenly based on clinical findings. These good mimickers masqueraded themselves as common etiologies of acute abdomen such as acute appendicitis, diverticulitis and cholecystitis. Conclusion: After radiographs, ultrasonography (US) and computed tomography (CT) are the most common imaging modalities that are performed in emergency departments for acute abdominal pain. Both US and CT are highly accurate imaging modalities that commonly reveal the correct diagnosis. However, rare disorders may not be recognized in the acute setting. We present our cases with US and CT images to remind radiologists and emergency physicians of these mimickers of acute abdominal pain in order to prevent unnecessary surgeries. [ABSTRACT FROM AUTHOR]

Omental torsion is due to the twisting of the omentum along its axis and is observed in young male patients. The first description of omental torsion was first made by Eitel in 1899. A 35-year-old male presented with right iliac fossa pain, nausea, occasional vomiting and loss of appetite for four days. His clinical and radiological findings were suggestive of acute appendicitis. However, he was diagnosed with greater omental torsion intraoperatively and successfully managed with laparoscopic omentectomy. Omental torsion is a rare condition with a low incidence. Preoperative diagnosis of omental torsion continues to be a challenge as the symptoms reported in the literature are usually confused with other abdominal pathologies such as appendicitis or cholecystitis etc. Preoperative US or CT scans are mandatory, and these procedures can accurately accomplish the pre-operative diagnosis. In search for the treatment of choice, laparoscopy proved its effectiveness as a diagnostic tool since it allows for confirming the diagnosis, evaluating the severity of the ischemia, and ruling out other surgical pathologies and therapeutic tools. At the same time, the open surgery approach can be described in many cases as being too invasive. Greater omental torsion should be considered a differential diagnosis in all patients with acute abdominal emergencies. • Omental torsion is due to the twisting of the omentum along its axis and is common in young male patients. • Preoperative diagnosis in omental torsion is challenging due to symptom overlap with appendicitis or cholecystitis. • Laparoscopy is an effective diagnostic and therapeutic tool for omental torsion; open surgery is an alternative. Omentectomy is successful treatment. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate multislice computed tomography (MSCT) findings of omental infarction, a rare cause of acute abdominal pain, together with a review of the current literature. The retrospective cross-sectional study included eighteen patients, between 2011 and 2015, who were admitted to our department with complaints of acute abdominal pain and who were subsequently diagnosed with omental infarction. Of these eleven patients, five (61%) were males and seven (39%) were females. The mean age was 48 years, ranging from 39 to 71 years. Radiologic imaging showed findings consistent with omental infarction localized to the ascending colon in six cases, descending colon in five cases, neighborhood of transverse colon in five patients, and neighborhood of the gall bladder in two patients. The size of the lesions ranged from 3 cm to 7 cm. Abdominal MSCT showing whirling pattern of vessels in the infarcted omental vessels and an oval-shaped dirty fat ball appearance with well-defined margins in the neighborhood of the colon. MSCT is superior to ultrasonography in the evaluation of omentum also allows rapid and accurate diagnosis of omental infarction and prevents unnecessary surgical interventions. [Med-Science 2017; 6(3.000): 415-7]

Omental infarction is a rare condition caused by the decrease in blood flow in the greater omentum. Although it is mostly seen secondarily to another underlying pathology, it can also emerge independent of any other reason. A 65-year-old female patient, who had no known comorbidity or previous history of surgery, presented with complaints of increasing pain for the last two days which was more pronounced in the right lower quadrant. The patient did not have other complaints like nausea, vomiting, lack of appetite, or fever accompanying abdominal pain. The patient was diagnosed with idiopathic omental infarction as shown by the results of tests, studies, and examinations conducted. The patient was treated conservatively and was discharged without any problems. Idiopathic omental infarction is a rare cause of acute abdomen which can generally limit itself. Although surgical intervention is necessary in cases with unspecified radiological results and bad clinical prognoses, unnecessary surgical procedures and anesthetic risks can be prevented by conservative treatment methods in patients with definitive diagnoses. [ABSTRACT FROM AUTHOR]

Introduction Medullary carcinoma is a rare type of colorectal adenocarcinoma, and omental infarction is a rare cause of acute abdomen. Presentation of case A 72-year-old woman underwent single-incision laparoscopic right hemicolectomy for ascending colon cancer. Pathological examination showed a medullary carcinoma (MC) of T4aN0M0 Stage IIB. Her postoperative course was uneventful, and she was discharged on postoperative day (POD) 6. From POD 7, she suffered from fever, and she returned to the hospital on POD 9. Plain computed tomography showed free air beside the anastomotic site around the elevated density of fat tissue and gallbladder wall thickening with a gallstone. Suspecting anastomotic leakage with acute cholecystitis, probe laparotomy was performed. Intraoperative observation confirmed omental infarction with acute cholecystitis, and no leakage was found at the anastomotic site. Therefore, the necrotic part of the greater omentum was resected, and cholecystectomy was performed. She has remained well, with no evidence of recurrent cancer during the 12 months of follow-up without chemotherapy after the surgery for MC of the ascending colon. Discussion MC should be distinguished from other more aggressive, non-glandular tumors of the colon because MC appears to have a better survival outcome than undifferentiated colon adenocarcinoma. Omental infarction should be considered in the differential diagnosis of acute abdomen after surgery. Conclusion A rare case of medullary carcinoma of the ascending colon followed by infarction of the greater omentum mimicking anastomotic leakage is presented. [ABSTRACT FROM AUTHOR]

Omental infarction is an uncommon cause of acute abdomen in the pediatric population. We report a case of a 4-year-old male child with right iliac fossa pain. The final diagnosis was made on ultrasound and computed tomography findings. This entity needs to be differentiated from acute conditions like appendicitis, avoiding surgery.

Omental infarction is a very rare cause of an acute abdomen in children. Symptoms, in particular, display a great similarity to those of appendicitis. A 10-year-old boy with omental infarction was successfully treated by laparoscopic excision. The authors have demonstrated that laparoscopic excision is a technically feasible and safe method associated with a shorter hospital stay, no requirement for analgesics and a good cosmetic outcome. [Arch Clin Exp Surg 2014; 3(4.000): 247-250]

Diagnosis of omental infarction, while rare, has become increasingly common likely due to improvements in diagnostic imaging. Reported incidence of omental infarction varies; however, omental infarction has not yet been described in association with colonoscopy. Common complications of colonoscopy include complications of sedation, complications of bowel preparation, and bleeding following polypectomy, and rarely, perforation or infection. We describe herein a case of a 63-year-old female who developed acute right lower quadrant abdominal pain following a colonoscopy. Abdominal computed tomography (CT) scan revealed omental infarction in the right lower quadrant. Conservative management was employed, and the patient was observed for resolution of symptoms. Repeat abdominal CT scan 2 weeks following initial presentation showed resolution of inflammatory changes associated with omental infarction. The patient also improved clinically. Omental infarction should be considered in patients presenting with acute abdominal pain following colonoscopy.