Presentation
Acute abdominal pain.
Patient Data
A large portion of the greater omentum appears hazy with concentric hyperdensity in the right lower abdomen and pelvis region, suggestive of omental infarction. It has a whirling pattern (whirl sign) in the superior aspect, suggestive of omental torsion.
An associated right inguinoscrotal hernia contains hazy omental fat only.
Case Discussion
Diagnostic laparoscopy and omentectomy were performed and a large portion of omentum was found to be ischemic. Histopathology revealed omental hemorrhage with non-specific inflammation.
A right-sided open hernia repair was also performed.
Torsion of the omentum is the main cause for infarction;
Causes of omental torsion include:
primary torsions (without other pathologic intra-abdominal findings)
secondary torsions (secondary to tumors, cysts, inflammatory changes, adhesions, hernias)
Co-authors: Dr. Sanjoy Kumar and Dr. Amanjee
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