Idiopathic segmental infarction of the greater omentum: A rare cause of acute abdomen

Idiopathic segmental infarction of the greater omentum is a rare cause of acute abdomen. Patients, typically children or obese males in their fifties, present with abdominal pain located in the right upper or lower quadrant, mimicking cholecystitis and appendicitis. CT scanning and ultrasound imaging both may show a well-circumscribed soft tissue mass. Retrospective review of all patients treated for idiopathic segmental infarction of the greater omentum occurred from January 1993 to December 2001. Nine patients were treated successfully, six surgically and three medically. Conservative management of segmental infarction of the greater omentum can be proposed when correctly diagnosed by ultrasound imaging or CT scanning and the patient’s condition is stable. If not, laparoscopic removal of the involved segment of the greater omentum is the treatment of choice.     

Primary torsion of the omentum in a 6-year-old boy: Report of a case

(Received for publication on Feb. 17, 1998; accepted on Nov. 6, 1998)     

Idiopathic Segmental Infarction of Right Sided Greater Omentum. Case report and review of the literature

Idiopathic right segmental infarction of the greater omentum is an uncommon cause of acute abdomen. The aetiology is still unclear and the symptoms mimick acute appendicitis. We present a case of a 77-year old man with unsignificant medical history, admitted with an acute abdomen, in whom the clinical diagnosis was unknown until an infarcted segment of right side of the greater omentum was found at laparoscopy, and successfully resected. As the aetiology is unknown, we highlighted some of the possible theories, and emphasize the importance of considering omental infarction in the differential diagnosis of right iliac fossa syndrome in cases of acute abdomen.     

Primary idiopathic segmental infarction of the greater omentum: two cases of acute abdomen in childhood

Idiopathic segmental infarction of the greater omentum (ISIGO) is a rare cause of acute abdominal pain in childhood. The authors present the case histories of 2 children treated in their department. The children underwent surgery with preoperative diagnosis of acute appendicitis with atypical clinical presentation. The definitive diagnosis of segmental infarction of the great omentum was made intraoperatively and confirmed pathologically. Excision of the infracted omentum was curative.     

Idiopathic segmental infarction of the greater omentum

Segmental infarction of the omentum is a rare disease, with about 150 published cases, and an unusual cause of "pseudoacute" abdomen. The preoperative diagnosis is difficult because of the rarity and lack of specificity of the syndrome, and it is established after laparotomy, with a few exceptions. The authors report on a personal case and emphasize the importance of systematic exploration in spite of the "innocence" of the organ initially involved, and they describe the few signs that are nontheless suggestive of this provocative and puzzling entity.     

原发性节段性大网膜梗死1例报告并文献复习

病人男性,26岁.因"右下腹痛1d"于2008-03-10入院.病人于入院1d前无明显诱因出现右下腹部隐痛,不放射.伴腹胀及排气,排便减少.无恶心、呕吐及腹泻症状.T 37.5℃.否认外伤及腹部手术史.查体:体型肥胖(体重指数BMI=38)腹部膨隆,右侧腹及右下腹压痛(+)、反跳痛(+),伴中度肌紧张.肠鸣音弱,1次/min.血常规:WBC 12.4×109/L,Neut 72.5%.血生化:丙氨酸氨基转移酶(ALT)58U/L,总胆红素(1FBIL)22.2μmol/L,直接胆红素(DBIL)9.3μmol/L,肌酐(CR)90μol/L,脂肪酶(LIP)194U/L.腹部B超:脂肪肝,余未见异常.立位腹平片:多发小肠扩张伴气液平面,考虑不全肠梗阻.胸片:右下肺见小斑片致密影,疑右下肺感染.     

Accessory spleen in the greater omentum

Although accessory spleen is a frequently encountered entity, accessory spleen in the greater omentum is rare. A 22-year-old woman presented with dull pain in the left upper abdomen. Cross-sectional imaging studies with 3-dimensional reconstruction suggested the presence of a huge tumor in the greater omentum that was associated with the spleen. At laparotomy, the diagnosis of accessory spleen was made. This accessory spleen was unusual in its size and location. Awareness of this entity and familiarity with typical imaging findings is mandatory for preoperative diagnosis. The importance of recognition and appropriate confirmatory diagnosis of an accessory spleen is discussed.     

Idiopathic segmental infarction of the greater omentum. Apropos of a new case]

Idiopathic segmental infarction of the greater omentum is an unusual cause of acute abdomen. The preoperative diagnosis is difficult. Before laparotomy the diagnosis is hardly ever considered; the authors report a personal case and describe etiologic hypotheses and the clinical picture of this disease.     

Spontaneous segmental infarction of the greater omentum

Spontaneous segmental infarction of the greater omentum, although rare, is probably more common than the 112 reported cases suggest, but its sporadic occurrence has lent itself more to isolated case reports than to an extensive overview of the disease. Despite the frequent preoperative diagnosis of appendicitis, the presentation and course are seldom typical of appendicitis. Progressive peritoneal signs finally dictate surgical exploration. A vertical incision provides the best access to the involved organs and should be used whenever the diagnosis of appendicitis is in doubt. A surgeon who encounters free serosanguineous peritoneal fluid and a normal appendix should suspect omental disease.No convincing etiology has yet been advanced although blunt trauma, whether substantial or trivial, may account for some cases. The close temporal and geographic relation of two of these cases has raised the question of infectious etiology; however there was no microbiologic or pathologic evidence of bacterial or viral infection.     

Primary torsion of the greater omentum: report of a case

Primary or idiopathic torsion of the greater omentum is an uncommon cause of acute abdominal pain, often mimicking other acute abdominal conditions. The diagnosis is usually made at laparotomy, with the presence of free serosanguinous fluid in the absence of any other intra-abdominal pathology being suggestive of this condition. Resection of the infarcted segment is the treatment of choice, offering rapid recovery and reducing the possibility of adhesion formation. We report a case of primary omental torsion and discuss the diagnostic and therapeutic implications of this entity. Received: September 7, 2001 / Accepted: March 5, 2002     

Leiomyoma of the lesser omentum: Report of a case

The case of a 67-year-old Japanese woman with leiomyoma arising from the lesser omentum is reported herein. Although the patient had no abdominal symptoms, findings of a routine abdominal ultrasound examination suggested a mass between the stomach and the lateral segment of the liver. Subsequent magnetic resonance imaging (MRI) demonstrated a 6-cm well-encapsulated tumor in the lesser omentum, and this was confirmed intraoperatively. Resection of the tumor was performed without any other procedure and the histological diagnosis was confirmed as leiomyoma. The patient has been well for the 6 months since her operation. To our knowledge, this is the first report in the English literature of leiomyoma arising from the lesser omentum.     

Primary leiomyosarcoma of the greater omentum: a case report

IntroductionGreater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.Presentation of caseWe report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.DiscussionSurgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.ConclusionMore cases are needed to define the best treatment approach of this disease.     

Pedicled greater omentum transfer to the thoracolumbar spine in a case of pyogenic spondylitis due to MRSA - a case report

A case report of 62-year-old male who was treated with a pedicled greater omentum transfer for thoracolumbar spondylitis due to methicilinresistant Staphylococcus aureus (MRSA) is given. Omentum transfer has been used in many anatomic sites such as scalp, face, oral cavity, upper digestive and respiratory tracts, chest wall, lower trunk, and lower limb since 1963.We report the successful healing to thoracolumbar spondylitis which has infectious dead space due to MRSA. Pedicled greater omentum transfer to the dead space of the infected spine is an option with recurrence of thoracolumbar spondylitis due to MRSA.     

Primary idiopathic segmental infarction of the greater omentum

A report is given of two cases of primary idiopathic segmental infarction of the greater omentum, emphasizing clinical and pathological features.Each case, without a history of antecedent violence, presented an infarct of a localized, distal segment of the greater omentum not associated with omental torsion and characterized by an absence of any co-incident intraperitoneal pathological condition.An explanation is suggested with regard to the etiology of this condition.