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01.12.2014 | Case report | Ausgabe 1/2014 Open Access

Journal of Medical Case Reports 1/2014

Omental whirl associated with bilateral inguinal hernia: a case report

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2014
Autoren:
Elsa Silva, Ana Franky Carvalho, Diogo Rocha, António Mesquita Rodrigues, Ricardo Pereira, Ana João Rodrigues, Pedro Leão
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-8-239) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

ES and PL evaluated the patient. AFC, AJR, AMR and PL were involved in drafting the manuscript and revising it critically for important intellectual content. DR was involved in CT scanning and imaging evaluation. PL, RP and ES performed the laparoscopic omentectomy and hernia repair. PL and AMR were involved in revising it critically and have given final approval of the version to be published. All authors read and approved the final manuscript

Abstract

Introduction

Torsion of the omentum is a rare cause of abdominal pain. It is clinically similar to common causes of acute surgical abdomen and is often diagnosed during surgery. Inguinal hernia is a common condition but not frequently related with torsion of the omentum.

Case presentation

A 40-year-old Caucasian man came to our emergency department with abdominal pain of the left quadrant and abdominal distension for 2 days. His medical history included an untreated left inguinal hernia in the last year. Computed tomography revealed densification of mesocolon with left omentum “whirl” component and other signs of omental torsion. During an exploratory laparoscopy, a wide twist of his omentum with necrotic alterations that extended to the bilateral inguinal hernial content was observed. Omentectomy and surgical repair of bilateral inguinal hernia were performed.

Conclusions

Torsion of the omentum is a rare entity and usually presents a diagnostic challenge. The use of abdominal computed tomography can help diagnosing torsion of the omentum preoperatively and, thus, prevents a surgical approach. Nonetheless, some cases of torsion of the omentum require surgical repair. Accordingly, a laparoscopic approach is minimally invasive and efficient in performing omentectomy.

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Zusatzmaterial
Authors’ original file for figure 1
13256_2014_2860_MOESM1_ESM.tif
Authors’ original file for figure 2
13256_2014_2860_MOESM2_ESM.tif
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