Segmental Omental Infarction

Abstract

Segmental omental infarction (SOI) is an unusual and rare cause of abdominal pain in children and is often mistaken for acute appendicitis preoperatively. SOI once diagnosed preoperatively should be treated conservatively. Surgical intervention, however, may be necessary in order to establish definitive diagnosis and treatment. We present 2 children with SOI diagnosed as acute appendicitis preoperatively. Laparoscopy established the diagnosis and treatment. Laparoscopy should be the procedure of choice in children presenting with right-sided abdominal pain that is not well established preoperatively. This is especially so in obese children. Laparoscopy not only establishes the diagnosis of SOI but laparoscopic omentectomy results in resolution of symptoms and faster recovery.

Swirling Fat

“…Omentum is a fat‐laden peritoneal remnant of embryological development. OI is a rare cause of acute abdomen in children and may mimic acute appendicitis, a common entity in childhood (1,2). Obesity is a known risk factor for OI (3).…”

Omental Infarction

“…In this setting, laparoscopy is the procedure of choice to inspect the whole peritoneal cavity. 8,12,[17][18][19] Only few retrospective case series have been published on this topic in children.…”

“…In addition, to make a preoperative diagnosis has also important surgical implication because the standard McBurney or any infraumbilical incision used for conventional appendicectomy may be inadequate for diagnosis and treatment of certain OI, especially in obese children. In this setting, laparoscopy is the procedure of choice to inspect the whole peritoneal cavity 8,12,17–19 . Only few retrospective case series have been published on this topic in children.…”