Intraperitoneal fat focal infarction of the lesser omentum: case report

Abstract

Intraperitoneal fat focal infarction (IFFI) represents a relatively rare acute abdominal condition essentially characterized by infarction and/or torsion of the greater omentum or an epiploic appendage. The spontaneous clinical evolution is favorable under medical treatment, and the imaging findings have been proved sufficiently typical to avoid unnecessary surgery in the great majority of cases. To our knowledge, we report the first case of IFFI of the lesser omentum. Despite the absence of definitive histologic proof, the diagnosis was possible through typical imaging findings extremely similar to those of more classic cases of IFFI but also through the spontaneous benign evolution.

Greater and Lesser Omenta: Normal Anatomy and Pathologic Processes

“…intestinal stromal tumor) (29). Although almost all of these tumors have variable and nonspecific CT features, some manifest with characteristic appearances.…”

A new case of intraperitoneal fat focal infarction (IFFI) of the lesser omentum

“…More recently, case reports have described much more rare types of IFFI concerning torsion of a lipomatous appendage of the falciform ligament and infarction of the lesser omentum [2,3].…”

Omental torsion: An uncommon cause of abdominal pain

“…Patients usually complain of nausea, vomiting, fever and abdominal pain. Because of these complains, acute appendicitis, cecal diverticulitis and acute cholecystitis may be thought for differential diagnosis (8,9) . In our case the patient was in fourth decade, and presented to the Emergency department with rightsided abdominal pain and nausea.…”

“…Preoperative diagnosis of omental torsion is difficult. Ultrasound and CT may help to identify the omental abnormality (9) . Sonographically, the classic presentation is that of a solid, noncompressible, painful, and moderately hyperechoic hyperattenuating mass in the vicinity of other normal abdominal structures or organs (9) .…”

“…Sonographically, the classic presentation is that of a solid, noncompressible, painful, and moderately hyperechoic hyperattenuating mass in the vicinity of other normal abdominal structures or organs (9) . CT findings, a well-circumscribed fatty inflammatory mass, surrounded by normal organs, circumscribed or covered by inflammatory peritoneum and containing hyperechoic streaks probably corresponding to fibrous bands and/or dilated thrombosed veins, are becoming more important to diagnose patients with omental torsion (9) . The CT findings of a fatty mass in the omentum may also suggest other diagnosis like lipoma, liposarcoma, angiomyolipoma, teratoma, mesenteric lipodystrophy (2) .…”