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Mzoughi Z, Ben Abid S, Bayar R, Talbi G, Gharbi L, Khalfallah MT. [Infarctus segmentaire du grand epiploon]. LA TUNISIE MEDICALE 2014; 92:695-696. [PMID: 25867156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Wu CX, Wu BQ, Duan YF, Sun DL, Jiang Y. Rare case of omentum-wrapped abscess caused by a fish bone penetrating the terminal ileum. World J Gastroenterol 2014; 20:11456-11459. [PMID: 25170236 PMCID: PMC4145790 DOI: 10.3748/wjg.v20.i32.11456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 03/18/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
Accidentally ingested foreign bodies, for the most part, pass through the gastrointestinal tract, but can cause several complications. Perforation is rare, but can occur in any segment of the gastrointestinal tract. Intestinal perforations due to foreign bodies are rarely diagnosed preoperatively as clinical symptoms are non-specific and they can mimic other abdominal conditions. We describe a case of a 48-year-old patient who was admitted to the emergency room because of severe abdominal pain of 5 d duration. A computed tomography scan showed an undefined liquid collection involving a linear image 35 mm in size, suggestive of a foreign body. On laparotomy, an abscess containing a fish bone was resected. As fish bone ingestion is usually not remembered by the patient, the diagnosis can be delayed. The preoperative diagnosis is frequently acute abdomen of unknown cause. A low threshold of suspicion along with a good clinical history and radiological studies are extremely important in order to make a correct diagnosis.
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Chassagnon G, Metrard G, Besse H, Gauvain S. 18F-FDG PET imaging in a patient with late omental infarction after treatment of pancreatic adenocarcinoma. Clin Nucl Med 2014; 39:567-9. [PMID: 24806607 DOI: 10.1097/rlu.0000000000000424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report a case of late omental infarction visualized by F-FDG PET/CT during follow-up for pancreatic adenocarcinoma. The 65-year-old patient was referred for imaging 8 months after pancreaticoduodenectomy and 2 months after completion of a course of chemotherapy. PET/CT showed an FDG-avid omental lesion that suggested peritoneal carcinomatosis. The appearance and evolution at follow-up studies confirmed the diagnosis of omental infarction, a rare complication of pancreatic surgery. This case revealed the possibility of late FDG uptake in omental infarction.
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Gasparri ML, Bellati F, Pernice M, Di Donato V, Morano G, Marchetti C, Donfrancesco C, Antonilli M, Benedetti Panici P. Surgical treatment of an isolated omental cervical cancer recurrence: report of a case and review of the literature. TUMORI JOURNAL 2014. [PMID: 24852877 DOI: 10.1700/1491.16437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND Recurrent cervical cancer has traditionally been associated with a dismal prognosis. Historically, patients who developed distant metastases from cervical cancer were not considered eligible for surgical resection; only palliative treatment options are available, generally consisting of chemo- and/or radiotherapy. Metastases usually appear in the liver, lung or lymph nodes. The abdominal cavity is a quite unusual site of recurrence and the disease usually has multiple foci. For this reason, peritoneal involvement by cervical cancer is considered a contraindication to local treatment. METHODS AND STUDY DESIGN We report the first case of a 30-year-old woman with isolated intra-abdominal cervical cancer recurrence diagnosed with 18F-FDG PET/CT, successfully surgically treated. RESULTS Histopathological analysis confirmed the tumor to be an omental relapse of squamous cervical cancer previously treated with anterior pelvic exenteration and platinum based chemotherapy. The patient underwent adjuvant treatment with 3 cycles of topotecan and has remained free of disease during the 4 years of follow-up. CONCLUSIONS In selected cases with isolated recurrences, a surgical resection may provide a long term complete remission in recurrent cervical cancer patients.
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Tajima H, Onozawa S, Isshiki S, Takenoshita N, Kaneshiro T, Ichikawa T, Murata S, Matsuda K, Furukawa A. Angiography-assisted computed tomography for the detection and intervention of a subtle aneurysm of the omentum. Jpn J Radiol 2014; 32:238-41. [PMID: 24481667 DOI: 10.1007/s11604-014-0287-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 01/09/2014] [Indexed: 12/01/2022]
Abstract
Intra-abdominal hemorrhage caused by omental artery rupture is a rare condition traditionally diagnosed via exploratory laparotomy in hemodynamically unstable patients. We experienced a case in which contrast-enhanced multidetector computed tomography (MDCT) and digital subtraction angiography did not identify the rupture site, whereas CT during left omental arteriography depicted a small 4-mm aneurysm. The lesion was then embolized with microcoils and N-butyl cyanoacrylate lipiodol glue. We consider that performing a CT during selective arteriography could be useful in cases in which the rupture site is unclear with other imaging techniques such as contrast-enhanced MDCT and digital subtraction angiography.
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Tesfalem H, Kleif J. [Primary omental actinomycosis]. Ugeskr Laeger 2014; 176:V06130418. [PMID: 25347178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report a case of omental actinomycosis in a female patient with an intrauterine device. A computed tomography had shown an inflammatory tumour in the abdomen. The patient was treated with laparoscopic resection of the tumour and prolonged antibiotic therapy. Abdominal actinomycosis should be considered as a differential diagnosis in patients with abdominal symptoms and unspecific clinical, radiological and laboratory findings. Definitive diagnosis of actinomycosis requires histological examination of affected tissue. Laparoscopic resection seems feasible as an alternative to open surgery.
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Karahan O, Eryilmaz MA, Okus A, Ay S, Unlu Y, Cayci M, Kaya M. Evaluating the effectiveness of spleen autotransplantation into the liver and the omentum. ACTA ACUST UNITED AC 2013; 114:610-5. [PMID: 24236427 DOI: 10.4149/bll_2013_130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Experimental research into the viability and functionality of splenic tissue placed in the liver and the omentum. METHODS There were 4 groups in this study. First group: sham laparotomy, 2nd group: splenectomy, 3rd group: splenectomy and splenic autotransplantation into the greater omentum and 4th group: splenectomy and splenic autotransplantation into the liver. Blood levels of haemoglobin, leukocytes, thrombocytes, immunoglobulin G (IgG), immunoglobulin M (IgM) and complement protein 3 (C3) were studied 1 day before and 6 weeks after the procedure. At the end of 6 weeks, scintigraphy was performed. Splenic tissue in the liver and the omentum were subjected to macroscopic and histopathologically. RESULTS Pre- and postoperatively, no significant differences were found in terms of haematological and immunological measurements of groups I, III and IV. An increase in the numbers of thrombocytes and leukocytes and a decrease in the levels of IgG, IgM and C3 were observed in the postoperatively in group II.When the postoperative hematological and immunological values of the second group are compared to those of groups III and IV, the difference was significant in terms of levels of thrombocyte, leukocyte and IgM; insignificant in terms of levels of IgG and C3. In the microscopic and scintigraphic analyses the spleen tissue was found to be viable in all of the six rabbits in groups III and IV. CONCLUSIONS The liver is a suitable organ for splenic autotransplantation (Tab. 6, Fig. 2, Ref. 17).
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Anila KR, Rema P, Jayasree K. Disseminated peritoneal leiomyomatosis clinically and radiologically mimicking malignancy. Int J Surg Pathol 2013; 22:158-9. [PMID: 24196195 DOI: 10.1177/1066896913507600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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59
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Maheshwari B, Khurana N, Sharma A. Peritoneal ascariasis presenting as granulomatous peritonitis and omental cyst. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2013; 34:265-267. [PMID: 25046891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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60
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Wang W, Wang ZJ, Webb EM, Westphalen AC, Gross AJ, Yeh BM. Omental infarction preceded by anatomically upturned omentum. Clin Imaging 2013; 37:1125-7. [PMID: 23932388 DOI: 10.1016/j.clinimag.2013.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/04/2013] [Accepted: 07/05/2013] [Indexed: 11/20/2022]
Abstract
We report the case of a 49-year-old man who presented with acute abdominal pain. Contrast-enhanced computed tomography of the abdomen revealed spontaneous omental torsion with no other noticeable findings. Notably, a computed tomography exam 6 months prior demonstrated the omentum located within the anterior hepatic space, suggesting that the patient had a hypermobile, upturned omentum. To our knowledge, this is the first case report illustrating an anatomically upturned omentum as precursor to omental infarction.
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Arner P, Andersson DP, Thörne A, Wirén M, Hoffstedt J, Näslund E, Thorell A, Rydén M. Variations in the size of the major omentum are primarily determined by fat cell number. J Clin Endocrinol Metab 2013; 98:E897-901. [PMID: 23543656 DOI: 10.1210/jc.2012-4106] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Accumulation of visceral adipose tissue (VAT) is strongly linked to insulin resistance. Variations in the size of any adipose depot are determined by alterations in adipocyte volume and/or number. The individual contribution of each of the latter factors was determined in the major omentum, a fully resectable VAT depot. SUBJECTS Total removal of the major omentum (omentectomy) was performed in conjunction with bariatric surgery in 55 obese patients. Tissue weight as well as mean adipocyte size and number in the omentum were determined. In subgroups, total VAT was estimated by computerized tomography (n = 17) or dual-energy x-ray absorptiometry (n = 34). RESULTS The weight of the major omentum (on average 0.6 kg) correlated significantly with total VAT mass estimated by computerized tomography or dual-energy x-ray absorptiometry (r = 0.48-0.7; P < .01). Omental weight in relation to total body fat correlated with several features of the metabolic syndrome and inversely with serum-leptin (P < .001). Mean adipocyte size and total adipocyte number correlated strongly with omental weight (r = 0.6-0.8; P < .0001), irrespective of body mass index and total body fat mass, and accounted almost in total for interindividual variations in omental size. However, stepwise regression analysis demonstrated that adipocyte number was significantly (P < .0001) more important (62%) than adipocyte size (35%). CONCLUSION The size of the major omentum is representative for VAT mass and correlates with a pernicious metabolic profile. Variations in omental weight are primarily determined by adipocyte number and to a lesser degree by adipocyte size, suggesting that increased VAT mass in obesity is predominantly dependent on adipocyte proliferation.
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Chen YJ, Ng YB, Chen W. Right thoracic stomach mimicking pleural empyema in an elderly man. QJM 2013; 106:189-90. [PMID: 22080100 DOI: 10.1093/qjmed/hcr224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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63
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Netz U, Perry ZH, Bayme MY, Dyomin V, Mizrahi S. Primary peritoneal sarcoidosis causing an omental cake. Am Surg 2013; 79:E6-E9. [PMID: 23317586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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64
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Vázquez GM, Manzotti ME, Perret C, Alessandrini G, Lemos S, Catalano HN. [Omental appendagitis]. Medicina (B Aires) 2013; 73:452. [PMID: 24152403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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65
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Pappou EP, Velopulos C, Fishman EK, Haut ER. Image of the month. Hernia containing omentum and right gastroepiploic artery. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 2012; 147:1065-6. [PMID: 23165622 DOI: 10.1001/archsurg.2011.2043b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
MESH Headings
- Abdomen, Acute/diagnosis
- Abdomen, Acute/etiology
- Catheters/adverse effects
- Emergency Service, Hospital
- Equipment Failure
- Female
- Follow-Up Studies
- Gastroepiploic Artery/diagnostic imaging
- Gastroepiploic Artery/pathology
- Hernia, Ventral/diagnostic imaging
- Hernia, Ventral/surgery
- Herniorrhaphy/methods
- Humans
- Kidney Failure, Chronic/diagnosis
- Kidney Failure, Chronic/therapy
- Middle Aged
- Omentum/diagnostic imaging
- Omentum/pathology
- Peritoneal Dialysis, Continuous Ambulatory/adverse effects
- Peritoneal Dialysis, Continuous Ambulatory/methods
- Risk Assessment
- Tomography, X-Ray Computed/methods
- Treatment Outcome
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Chen CQ, Ding WX. A lesser omental hernia through both the gastrocolic and gastrohepatic omenta. Am Surg 2012; 78:E282-E283. [PMID: 22691330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Cho HJ, Kim SJ, Lee SW, Moon SW, Park JH. Pseudotumor of the omentum associated with migration of the ingested crab-leg. J Korean Med Sci 2012; 27:569-71. [PMID: 22563227 PMCID: PMC3342553 DOI: 10.3346/jkms.2012.27.5.569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 02/13/2012] [Indexed: 12/31/2022] Open
Abstract
Foreign body ingestion is not uncommon in clinical practice, and it may occasionally lead to penetration injuries. Emergency physicians and radiologists sometimes fail to obtain complete histories including ingestion and may overlook the possibility of foreign body-induced complications. Herein, we report a case of stomach antrum perforation due to foreign body migration. We were unaware of the patient's history of eating the Korean delicacy "Kanjang-gaejang," which is raw crab seasoned with soy sauce. Several imaging diagnostic modalities had suggested the possibility of a malignant mass in the gastrocolic ligament area. During the operation, a crab leg was discovered as the cause of an intra-abdominal abscess. The patient underwent an antrectomy, a vagotomay, and a transverse colon wedge resection. We present this unusual case of a pseudotumorous lesion caused by ingestion of Kanjang-gaejang.
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Cheng W, Zhu Z, Jin X, Chen L, Zhuang H, Li F. Intense FDG activity in the brown adipose tissue in omental and mesenteric regions in a patient with malignant pheochromocytoma. Clin Nucl Med 2012; 37:514-515. [PMID: 22475909 DOI: 10.1097/rlu.0b013e31824d2121] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 39-year-old man who had a history of surgical excision of left adrenal pheochromocytoma 3 years ago underwent an FDG PET/CT scan to evaluate possible metastatic/recurrent disease. In addition to multiple FDG-avid lesions typical of hypermetabolic malignant disease and the FDG uptake in regions rich in brown adipose tissue, there was also intense FDG activity in the omental and mesenteric regions, which are not common locations of elevated FDG activity. On the repeat FDG PET/CT scan 3 days later after the patient was prepared with propranolol, the omental and mesenteric FDG activity was diminished.
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69
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Kim HC, Yang DM, Jin W, Joh JH. Infarction of lesser omental fat mimicking an exophytic pancreatic tumor by sonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:412-414. [PMID: 21449000 DOI: 10.1002/jcu.20806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 01/18/2011] [Indexed: 05/30/2023]
Abstract
We report a case of infarction of lesser omental fat in a 30-year-old woman who presented with epigastric pain. Sonography revealed a painful echogenic mass in the epigastrium that could not be separated from the adjacent hyperechoic pancreas and mimicked an exophytic pancreatic tumor. On CT, the mass was identified as an inflammatory lipomatous mass in the lesser sac, leading to the diagnosis of infarction of lesser omental fat. The patient was successfully treated conservatively.
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Rebai W, Ksantini R, Chebbi F, Makni A, Chenitir A, Ayadi S, Daghfous A, Fteriche F, Bedioui H, Jouini M, Kacem M, Ammous A, Ben safta Z. [Idiopathic infarction of the greater omentum]. LA TUNISIE MEDICALE 2011; 89:214-215. [PMID: 21308638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Hsu H, Gueng MK, Tseng YH, Wu CC, Liu PH, Chen CCC. Adenocarcinoma arising from colonic duplication cyst with metastasis to omentum: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:41-43. [PMID: 20812340 DOI: 10.1002/jcu.20739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Gastrointestinal tract duplications are uncommon congenital abnormalities. Carcinoma arising from duplication cyst is extremely rare, not to mention metastasis to other organs. We present a case of adenocarcinoma arising from a colonic duplication cyst with invasion of the serosa and metastasis to the omentum in a 40-year-old man. Duplication cysts should be included in the differential diagnosis of cystic masses of the gastrointestinal tract. Because these lesions occur so infrequently, they are often not suspected until encountered intraoperatively. The specific findings and advantages of sonography are reviewed.
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Ekıcı Y, Uysal S, Güven G, Moray G. Solitary fibrous tumor of the lesser omentum: report of a rare case. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2010; 21:464-466. [PMID: 21332007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We herein describe the case of a 51-year-old male who presented with a mass of the epigastric region. Preoperative contrast enhanced abdominal computerized tomography revealed a solid mass between the left liver lobe and stomach. Histopathologic examination diagnosed the mass as a solitary fibrous tumor. Although solitary fibrous tumors are rare, especially in the abdomen of adults, they are generally benign, but malignant cases have also been reported. Long-term follow-up will be necessary to determine whether the surgery has been curative.
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Vukomanovic P, Karanikolic A, Stefanoviic M, Mihajlovic D, Djordjevic B, Kutlesic R. Late recurrence of malignant melanoma mimicking ovarian malignancy. EUR J GYNAECOL ONCOL 2010; 31:590-592. [PMID: 21061811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Malignant melanoma (MM) is an extremely malignant tumor with an unpredictable profile of spread and variable periods of remission. CASE We describe an unusual case of malignant melanoma metastatic to the omentum occurring seven years after diagnosis and treatment of cutaneous malignant melanoma in the patient's arm. She received surgery and chemoimmunotherapy. To date, nine months after detection of malignant melanoma metastatic to the omentum, the patient is alive with no clinical and radiological metastatic disease. CONCLUSIONS The diagnosis of omentum malignant melanoma in a living patient is uncommon, thus very few individuals and referral centers can build up an adequate experience of handling this disease. Optimal management has been a challenge and a subject of debate and has not yet been established.
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Desai G, Filly RA. Sonographic anatomy of the gastrohepatic ligament. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:87-93. [PMID: 20040779 DOI: 10.7863/jum.2010.29.1.87] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this presentation is to illustrate anatomic and pathologic features of the gastrohepatic ligament (GHL) and to show its usefulness for precise localization of abnormalities, particularly in relation to the lesser peritoneal cavity and diseases occurring within the confines of the ligament itself. METHODS Cases were selected that illustrate the objectives above. RESULTS Illustrations show various anatomic and pathologic features meant to enhance interpretation of left upper quadrant sonograms. CONCLUSIONS Illustrations seen in the sonographic literature vaguely interpret the relationships of the GHL. Misunderstanding has led not only to improper nomenclature but also to the use of inappropriate indicators of lesser omental diseases. With a clear understanding of the anatomy of the GHL and its use as a pivotal marker for structures around and within it, one can avoid these pitfalls and better evaluate adult and pediatric lesser omental anatomy.
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Itenberg E, Mariadason J, Khersonsky J, Wallack M. Modern management of omental torsion and omental infarction: a surgeon's perspective. JOURNAL OF SURGICAL EDUCATION 2010; 67:44-47. [PMID: 20421090 DOI: 10.1016/j.jsurg.2010.01.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 01/19/2010] [Accepted: 01/25/2010] [Indexed: 05/29/2023]
Abstract
Omental infarction is a rare cause of acute abdomen that until recently was diagnosed only on exploratory surgery for presumed acute appendicitis or similar abdominal emergency. The increasing use of high-quality imaging, especially computerized tomography, in the diagnosis of appendicitis and the acute abdomen, has allowed preoperative diagnosis to be made much more often. Coupled with the increasing popularity of laparoscopic appendectomy, this finding has led to a spate of recent reports of omental infarction and omental torsion. It has also sparked a debate as to the best management of omental infarction, with strong support for both nonoperative management and definitive laparoscopic surgery. We present a case of omental torsion diagnosed preoperatively by the characteristic whirl sign and ultimately treated by laparoscopic surgery together with a brief review of the condition and our own recommendations.
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