VASCULAR PATHOLOGY OF THE GREATER OMENTUM: Report of two cases

Primary omental infarct: conservative vs operative management in the era of ultrasound, computerized tomography, and laparoscopy

“…Some authors advocate conservative management [2,4,6,8], whereas others feel that surgical intervention is advantageous, especially in the era of laparoscopy. The advocates of the laparoscopic approach argue that omental torsion managed conservatively requires long hospitalization and intensive narcotic use because of the severity of pain associated with this condition and risks the potential complications such as abscess formation, whereas laparoscopy allows for a faster recovery, low incidence of complications, and less analgesic requirement [3,5,10,15,16].…”

“…Idiopathic omental infarct was first described by Bush in 1896, and in 1899, Eitel described infarction associated with omental torsion [1,8,10]. Most cases occur in adults with only 15% presenting in children.…”

“…The increasingly frequent use of US and CT in children with abdominal pain allows for the diagnosis to be made preoperatively in most cases. Ultrasound is accurate but operator dependent; the sonographic criterion for the diagnosis of omental infarct is the identification of a hyperechoic mass mainly in the right side of the abdomen with a normal appendix [2,8,14] (Fig. 1).…”

“…It is often confused with other surgical conditions, but it mainly resembles acute appendicitis [1][2][3][4]. Omental infarct in children accounts for approximately 15% of all cases reported (most occur in adults) and is found in 0.1% of children undergoing abdominal exploration for acute appendicitis [3][4][5][6][7][8]. The incidence of this condition has been reported with increasing frequency in the past few years; this trend seems to be related to the prevalence of obesity among children and adolescents [1,4,9,10].…”

Clinical Characteristics of Torsion of the Omentum

“…By 1908 approximately 112 cases had been described [2], and in 1991 Coppo gathered data on nearly 150 cases [3, 4]. The first cases of omentum pathology at the Hospital General Regional 36, at the Instituto Mexicano del Seguro Social in Puebla, Mexico, were reported in 1998 [5] and 2004 [6]. By 2001, slightly fewer than 300 cases had been reported, 85% of them in the adult population and the remaining 15% in the pediatric population, almost all diagnosed as acute appendicitis and discovered during an exploratory laparotomy [1].…”