Omental Infarction in Pediatric Patients: Sonographic and CT Findings

Abstract

In pediatric patients with omental infarction, both CT and sonography show a heterogeneous mass characteristically situated between the anterior abdominal wall and the colon. It is important for radiologists to recognize the characteristic imaging findings seen with omental infarction.

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

“…The typical CT appearance is a solitary, well-defined, triangular or ovoid mass between the abdominal wall and transverse or ascending colon that has a heterogeneous, sometimes whorled pattern of linear fat strands, and surrounding fat infiltration may be present (4). In this study, the CT findings were typical, a mass between the abdominal wall and ascending colon of the RLQ in six patients and a similar lesion of the RUQ in one.…”

“…The lesion is typically found in the RLQ, just under the abdominal wall overlapping the right colon (4,5). In our study, two patients had a heterogeneous ill-defined fatty mass in the RLQ and one in the RUQ, located between the abdominal wall and the right colon.…”

“…Although relatively common in adults, it is rare in children, who account for only 15% of cases (2). Helm- (4)(5)(6). Thrombosis of an omental vessel due to a heavy meal or obesity can also induce omental infarction (7,8).…”

Pediatric omental infarction: Value of the laparoscope

“…Further associations have been reported between pediatric omental infarction and vasculitis [2]. Anatomical variations to the omentum may predispose pediatric patients to omental infarction in the postprandial state [3]. Obesity has been implicated as a risk factor for primary omental infarction in children and the inflammatory effects of adipose tissue may also contribute to the pathogenesis of this condition [4].…”

“…Age and sex have both been studied and shown to have a causative association with omental infarction. Eighty five percent of all reported cases of omental infarction occur in adults, with a predominance in the 4th and 5th decades of life [3,6]. Males have a 2:1 predominance over females and this may be due to an increased amount of fat in the male omentum [1,5].…”