Presentation
Left lower quadrant pain, rule out diverticulitis. WBC count 8000/μL.
Patient Data
Bilateral exophytic renal cysts. There is fat stranding with acute inflammatory changes surrounding the peritoneal fat in the lower left abdomen. While there is diverticular disease in the adjacent colon there is no colonic wall thickening, favoring omental infarct as the source of the patient's pain. Bilateral hip prosthesis present.
Case Discussion
This patient presented with left lower quadrant pain of unspecified duration and a WBC of 8,000/μL. The initial differential diagnoses included diverticulitis, omental infarction, and sigmoid volvulus. A CT abdomen/pelvis was ordered to provide diagnostic insight. The findings on imaging were most consistent with an omental infarct in the left lower quadrant. Findings on imaging suggestive of omental infarct include a focal area of fat stranding, a hyperdense peripheral halo, and possibly swirling of the omental vessels if the primary etiology is volvulus.
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