Left-sided omental torsion: CT appearance

Abstract

A 34-year-old male presented with exquisite left flank pain. Computed tomography showed a hyperdense vascular structure surrounded by whirling linear streaks situated in the greater omentum under the splenic flexure of the colon. Omental stranding extended caudally into the pelvis where part of the inflamed omentum entered a left inguinal hernia sac. Surgery revealed left-sided torsion of the greater omentum. Left-sided omental torsion is infrequent and pre-operative diagnosis is rarely established. The CT findings of an omental fatty mass with a whirling pattern is characteristic of omental torsion. Preoperative diagnosis is important because conservative management has been suggested.

Omental torsion: a diagnostic challenge

“…The precipitating factors include sudden increase in intra-abdominal pressure following a heavy meal or exertion, change in body position, coughing or sneezing, and occupational use of vibrating tools. 8,9 Obesity has also been implemented as a risk factor. 1,10 Secondary torsion is more common and a result of underlying abdominal pathology (e.g.…”

Computed Tomography and Ultrasound of Omental Infarction in Children: Differential Diagnoses of Right Lower Quadrant Pain

“…It is associated with several predisposing factors, such as obesity, venous congestion after a large meal, vascular kinking, and rarely, blunt trauma (4-9). Left-sided acute omental infarction is far less common than right-sided (8,11).…”

Torsión Secundaria Del Omento Mayor: Una Causa Poco Frecuente De Dolor en Hernia Inguinal Complicada

“…La torsión secundaria suele estar asociada a patologías abdominales: hernias, tumores o adherencias 3 . Dado que la mayoría de los casos descritos afectan el lado derecho, es muy importante tenerla en cuenta como diagnóstico diferencial del dolor abdominal en dicho lado, ya que puede simular colecistitis, apendicitis aguda, o incluso apendagitis 4 . Ante la presencia de una hernia inguinal complicada, la principal sospecha clínica es habitualmente la incarceración de asas, siendo la lesión del epiplón una etiología excepcional de la misma.…”