Idiopathic omental infarction: One for conservative or surgical management?

Lindley, S.; Peyser, P

doi:10.1093/jscr/rjx095

Cited by 19 publications

(22 citation statements)

References 8 publications

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“…Necrosectomy offers a shorter time to recovery. 7 Itenberg et al argue that, if a diagnosis can be confidently obtained on imaging with clinical correlation, conservative management must be attempted. However diagnostic laparoscopy must be undertaken with failure of symptoms to resolve or if a diagnosis is doubtful.…”

Section: Discussionmentioning

confidence: 99%

Primary omental infarction: a report of a series of cases in an Indian tertiary care hospital

et al. 2020

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Primary omental infarction is a relatively rare and often presents as right sided abdominal pain. It is often diagnosed as appendicitis and is usually picked up intra-operatively, or - as often seen nowadays - on imaging. We describe a series of four cases of primary omental infarction that presented to us with varying clinical features. Three of them had a short history of right sided abdominal pain, whereas the fourth patient had a longer history of left sided abdominal pain. All 4 were managed operatively, with the fourth having presented with an intra-abdominal abscess that required laparotomy. Primary omental infarction is a diagnosis which must be considered in any case of acute abdomen. Cases diagnosed with certainty on imaging may be managed conservatively but must be followed up closely. Need for surgical intervention should be considered in select cases.

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Section: Discussionmentioning

confidence: 99%

Primary omental infarction: a report of a series of cases in an Indian tertiary care hospital

et al. 2020

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“…Furthermore, these patients showed a quick improvement in clinical conditions without adverse clinical features and they were clinically stable. For this reason, encouraged by the more recent literature, we prescribed conservative management (i.e., hydration, analgesics, anti-inflammatories and prophylactic antibiotics) (Kerem et al 2005;Goh and Koong 2006;Estevão-Costa et al 2014;Tonerini et al 2015;Lindley and Peyser 2018).…”

Section: ; Abdulaziz Et Al 2013)mentioning

confidence: 99%

“Tethered Fat Sign”: The Sonographic Sign of Omental Infarction

Esposito

Ferrara

Schillirò

et al. 2020

Ultrasound in Medicine & Biology

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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 3À15 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.

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“…To date, 400 cases have been documented in the literature. 5,6 Due to this low incidence, and its variable and non-specific presentation, OI often may be initially misdiagnosed. The most likely differential diagnoses include acute appendicitis, acute cholecystitis, and ovarian cyst torsion.…”

Section: Dear Editormentioning

confidence: 99%

“…5,6 Nonetheless, operative intervention has risks and there are few reports of omental abscess after conservative management. 5 Thus, it is questionable to perform surgery in OI as a first-line treatment, mainly because OI is a self-limited condition, which is probably due to the rich vascularization of the greater omentum. In most reports, surgical intervention is reserved for the cases of uncertain diagnosis, irritation peritoneal signs (e.g.…”

Section: Dear Editormentioning

confidence: 99%