Infarto de omento mayor. Presentación de dos casos con un tratamiento conservador

Abstract

Omental infarction is a rare cause of acute abdominal pain. Cases. The report is based on two cases who attended to emergency, complaining of abdominal pain with CT diagnosis of omental infarction. We present a case of a 42 years old man who consulted to the emergency service for a pain in the right hemiabdomen, with elevated inflammatory markers in blood tests. Radiological examination by abdominal CT showed an omental torsion infarction. The patient evolved favourably with conservative treatment. The second case is a 85 years old man appendectomized who consulted for a pain in the left iliac foza with physical examination and complementary and radiological, it is concluded that it is an omental infarction, with a good evolution due to the treatment. Discussion. Clinical diagnosis remains a challenge, due to its rarity and clinical presentation mimicking acute appendicitis or cholecystitis. Hence in the absence of imaging test, intraoperative diagnosis takes place. It can occur due to two main pathogenic mechanisms: Secondary to vascular pedicle torsion (primary or secondary to another abdominal pathology) or situations that predispose to thrombosis. Conclusion. Omental infarction should be considered in the differential diagnosis of acute abdominal pain. Once confirmed by CT abdominal scan, conservative treatment could be considered, avoiding unnecessary surgery.

Infarto del omento: tratamiento por laparoscopia

“…El tratamiento puede ser conservador (85 % de los casos) 4 , con excelentes resultados, o quirúrgico 5 , con una rápida resolución del cuadro doloroso, evitando complicaciones, como formación de colecciones y adherencias. La cirugía laparoscópica es de utilidad en el diagnóstico y la terapéutica 5 .…”