Abstract
Idiopathic segmental infarction of the greater omentum is a rare disorder presenting with nonspecific clinical symptoms that may mimic a variety of acute abdominal conditions. We describe the diagnosis and treatment of two patients who had idiopathic infarction of the greater omentum and presented with localized abdominal pain, mimicking acute cholecystitis and acute diverticulitis, respectively. Patients underwent unenhanced multidetector-row computed tomography (CT) examination, which demonstrated the characteristic features of omental infarction, consisting of a heterogeneous density fatty mass, containing hyperattenuating streaks, located in the greater omentum, between the anterior abdominal wall and the colon; a moderate amount of free peritoneal fluid was also present. There were no other pathological abdominal findings. Giving persisting and worsening symptoms, both patients underwent laparoscopy with resection of the necrotic portion of the omentum. Pathology confirmed the preoperative diagnosis. Unenhanced CT allows us to obtain a reliable diagnosis of omental infarction in patients with acute abdominal pain and may help in selecting the appropriate medical or surgical therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bush P (1896) A case of hemorrhage into the greater omentum. Lancet 1:286
van Breda Vriesman AC, Lohle PN, Coerkamp EG et al (1999) Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history. Eur Radiol 9:1886–1892
Goti F, Hollmann R, Stieger R et al (2000) Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: report of case. Surg Today 30:451–453
van Breda Vriesman AC, Puylaert JB (2002) Epiploic appendagitis and omental infarction: pitfalls and look-alikes. Abdom Imaging 27:20–28
Paroz A, Halkic N, Pezzetta E et al (2003) Idiopathic segmental infarction of the greater omentum: a rare cause of acute abdomen. J Gastrointest Surg 7(6):805–808
Coulier B (2005) Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment. Pediatr Radiol 22:1–3
Grattan-Smith JD, Blews DE, Brand T (2002) Omental infarction in pediatric patients: sonographic and CT findings. AJR Am J Roentgenol 178(6):1537–1539
Leitner MJ (1952) Torsion, infarction and hemorrhage of the omentum as a cause of acute abdominal distress. Ann Surg 135:103–110
Naffaa LN, Shabb NS, Haddad MC (2003) CT findings of omental torsion and infarction: case report and review of the literature. J Clinical Imaging 27:116–118
Kim J, Kim Y, Cho OK et al (2004) Omental torsion: CT features. Abdom Imaging 29:502–504
Stella DL, Schelleman TG (2000) Segmental infarction of the omentum secondary to torsion: ultrasound and computed tomography diagnosis. Australas Radiol 44:212–215
Wiesner W, Kaplan V, Bongartz G (2000) Omental infarction associated with right-sided heart failure. Eur Radiol 10(7):1130–1132
Karayiannakis AJ, Polychronidis A, Chatzigianni E et al (2002) Primary torsion of the greater omentum: report of a case. Surg Today 32:913–915
Puylaert JB (1992) Right-sided segmental infarction of the omentum: clinical, US and CT findings. Radiology 185:169–172
Karak PK, Millmond SH, Neumann D et al (1998) Omental infarction: report of three cases and review of the literature. Abdom Imaging 23:96–98
McClure MJ, Khalili K, Sarrazin J et al (2001) Radiological features of epiploic appendagitis and segmental omental infarction. Clin Radiol 56:819–827
Coulier B, Pringot J (2002) Infarction of the greater omentum: can US and CT findings help to avoid surgery? Pictorial essay. JBR-BTR 85:193–199
Singh AK, Gervais DA, Hahn PF et al (2005) Acute epiploic appendagitis and its mimics. Radiographics 25:1521–1534
Garant M, Taourel P, Fried GM et al (1995) Thickening of the transverse colon associated with torsion of the greater omentum. AJR Am J Roentgenol 165:1309
Lardies JM, Abente FC, Napolitano A et al (2001) Primary segmental infarction of the greater omentum: a rare cause of RLQ syndrome: laparoscopic resection. Surg Laparosc Endosc Percutan Tech 11:60–62
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cianci, R., Filippone, A., Basilico, R. et al. Idiopathic segmental infarction of the greater omentum diagnosed by unenhanced multidetector-row CT and treated successfully by laparoscopy. Emerg Radiol 15, 51–56 (2008). https://doi.org/10.1007/s10140-007-0631-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10140-007-0631-z