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Lee SJ, Le KDR, Mark P. Spontaneous omental infarction as a rare differential for right iliac fossa pain: A case report and review of the literature. Clin Case Rep 2024; 12:e9151. [PMID: 38962458 PMCID: PMC11220499 DOI: 10.1002/ccr3.9151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/31/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
Omental infarction is a rare cause of acute abdominal pain, often benign and self-limiting. The significance of infarction lies in the fact that it can mimic other abdominal pathologies including appendicitis, cholecystitis, pancreatitis, or reflux disease. Diagnostic laparoscopy provides the definitive diagnosis of omental infarction, but it is invasive and limited due to resources. Computed tomography of the abdomen and pelvis has been considered the gold standard to diagnosing omental infarction when a non-invasive diagnostic approach is required. Additionally, ultrasound can also be used alternatively for children. Currently, there is no consensus in the diagnosis and management of patients with imaging-proven omental infarction. Spontaneous infarcted omentum must be considered by surgeons and radiologists as a rare cause of acute abdominal pain as patients can experience good outcomes with either conservative or operative approach. However, conservative management must only be considered in stable patients where alternative pathology is unlikely.
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Affiliation(s)
- Su Jin Lee
- Department of General Surgical SpecialtiesThe Royal Melbourne HospitalMelbourneVictoriaAustralia
- Department of RadiologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Khang Duy Ricky Le
- Department of General Surgical SpecialtiesThe Royal Melbourne HospitalMelbourneVictoriaAustralia
- Department of Surgical OncologyPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Geelong Clinical SchoolDeakin UniversityGeelongVictoriaAustralia
- Department of Medical Education, Melbourne Medical SchoolThe University of MelbourneMelbourneVictoriaAustralia
| | - Peter Mark
- Department of RadiologyThe Royal Melbourne HospitalMelbourneVictoriaAustralia
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2
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Aralihond A, Aniapravan R, Abdelgadir I, Powell C. Omental infarction in an overweight child: conservative treatment is a safe approach. BMJ Case Rep 2023; 16:e256232. [PMID: 37945275 PMCID: PMC10649688 DOI: 10.1136/bcr-2023-256232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
A previously healthy but overweight (body mass index (BMI) of 24.4) adolescent boy presented with fever and significant right-sided abdominal pain. An abdominal ultrasound scan revealed an omental infarction (OI), which was treated conservatively. OI has been described in overweight teenage children with abdominal trauma but can be missed if not considered. A missed diagnosis could result in an unnecessary laparotomy or laparoscopic surgery. Although CT is the gold standard for diagnosis, ultrasonography is an effective approach to identifying OI in children. The benefits of early diagnosis of OI by abdominal ultrasound include a shorter hospital stay and a reduction in unnecessary investigations and surgery.
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Affiliation(s)
| | | | | | - Colin Powell
- Emergency Department, Cardiff University, Cardiff, UK
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3
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Zhang AY, Griffin GM, Karrington BA, Tamura GS. Case Report: A Child With Omental Infarction. J Emerg Med 2023; 64:638-640. [PMID: 37032205 DOI: 10.1016/j.jemermed.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/11/2022] [Accepted: 02/17/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Omental infarction (OI) is a rare cause of acute abdominal pain, which is benign and self-limited. It is diagnosed by imaging. The etiology of OI is either idiopathic or secondary and due to torsion, trauma, hypercoagulability, vasculitis, or pancreatitis. CASE REPORT Here, we present a case of OI in a child with acute severe right upper quadrant pain. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Correct diagnosis of OI via imaging can prevent unnecessary surgery.
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Affiliation(s)
- Angela Y Zhang
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Georgia M Griffin
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Baer A Karrington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Glen S Tamura
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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4
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Hwang JK, Cho YJ, Kang BS, Min KW, Cho YS, Kim YJ, Lee KS. Omental infarction diagnosed by computed tomography, missed with ultrasonography: A case report. World J Clin Cases 2023; 11:972-978. [PMID: 36818623 PMCID: PMC9928693 DOI: 10.12998/wjcc.v11.i4.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Omental infarction (OI) is a surgical abdominal disease that is not common in adults and is very rare in children. Similar to various acute abdominal pain diseases including appendicitis, diagnosis was previously achieved by diagnostic laparotomy but more recently, ultrasonography or computed tomography (CT) examination has been used.
CASE SUMMARY A 6-year-old healthy boy with no specific medical history visited the emergency room with right lower abdominal pain. He underwent abdominal ultrasonography by a radiologist to rule out acute appendicitis. He was discharged with no significant sonographic finding and symptom relief. However, the symptoms persisted for 2 more days and an outpatient visit was made. An outpatient abdominal CT was used to make a diagnosis of OI. After laparoscopic operation, his symptoms resolved.
CONCLUSION In children’s acute abdominal pain, imaging studies should be performed for appendicitis and OI.
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Affiliation(s)
- Jae Kyoon Hwang
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
| | - Yu Jeong Cho
- Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
| | - Bo Seung Kang
- Department of Emergency Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
| | - Kyueng-Whan Min
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
| | - Young Seo Cho
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
| | - Yong Joo Kim
- Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, South Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Gyeonggi-do, South Korea
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Omran K, Al Tamr WJ. Omental infarction and anterior wall adhesion presenting as surgical abdomen in a pediatric patient. Clin Case Rep 2022; 10:e6604. [PMID: 36415712 PMCID: PMC9675865 DOI: 10.1002/ccr3.6604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/30/2022] [Indexed: 11/21/2022] Open
Abstract
Omental infarction is a rare cause of acute abdomen that can present in both the pediatric and adult populations causing adhesions or abscesses. Presentation may mimic appendicitis; however, ultrasonography may not be sufficient. We discuss the importance of CT imaging for the pre-surgical diagnosis to avoid serious port-site injuries.
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Affiliation(s)
- Kareem Omran
- GKT School of Medical EducationKing's College LondonLondonUK
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6
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Roy A, Mah JJ, Ambikapathi T, Mra A, Hayati F. A challenging case of spontaneous idiopathic omental infarction in a trisomy 21 patient. Ann Med Surg (Lond) 2022; 78:103760. [PMID: 35734697 PMCID: PMC9206908 DOI: 10.1016/j.amsu.2022.103760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Omental infarction (OI) is a rare cause of acute abdominal pain that is often missed out. Due to its non-specific presentation can mimic other commoner conditions such as acute appendicitis, acute diverticulitis, and tuberculosis abdomen. Case presentation We present a 42-year-old gentleman with trisomy 21 presenting right iliac fossa pain. Examination revealed tenderness in the right lower quadrant and blood parameters showed leucocytosis. With an initial impression of acute appendicitis, the patient was subjected to surgery. Intraoperatively, there were abnormalities to the omentum suggestive of OI, resulting in partial omentectomy. Symptom resolution occurred immediately and the patient was discharged early. Conclusion OI is a rare cause of acute abdomen that can mimic other abdominal pathologies. In trisomy 21 patients who present with acute abdomen, thorough assessments including preoperative imaging are advisable. Diagnostic laparoscopy is recommended as OI can be managed via minimally invasive surgery, hence ensuring good surgical outcomes. Omental infarction (OI) is a rare cause of acute abdominal pain that is often misdiagnosed, especially among those who present with right iliac fossa pain. In trisomy 21 patients who present with acute abdomen, thorough assessments including preoperative imaging are advisable. Diagnostic laparoscopy is recommended as OI can be managed via minimally invasive surgery, hence to ensure good surgical outcomes.
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Di Nardo G, Di Serafino M, Gaglione G, Mercogliano C, Masoni L, Villa MP, Parisi P, Ziparo C, Vassallo F, Evangelisti M, Vallone G, Esposito F. Omental Infarction: An Underrecognized Cause of Right-Sided Acute Abdominal Pain in Children. Pediatr Emerg Care 2021; 37:e1555-e1559. [PMID: 33170567 DOI: 10.1097/pec.0000000000002114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the prevalence of omental infarction (OI) in children with suspected appendicitis, the role of ultrasonography (US) in its diagnosis and management and the efficacy of conservative management. METHODS Consecutive children with suspected acute appendicitis were prospectively enrolled. Ultrasonography was performed at baseline, during follow-up, before the discharge, and at 15-day intervals until US findings of OI disappeared. All children with a diagnosis of OI were treated conservatively. RESULTS One hundred ninety-nine children (91 male; age range, 3-15 years) were evaluated. Eighty-four patients had acute appendicitis. Omental infarctions were found in 14 children (8 male; mean age, 9.8 ± 2.6 years), with an incidence of 7%. Ultrasonography depicted an echogenic mass consistent with OI in all children. Ultrasonography detected in 8 patients a normal-looking appendix, whereas in other 6 patients, it identified neither appendix nor indirect signs of acute appendicitis. A normal appendix has been detected by US during follow-up in 2 of these 6 patients. During follow-up, US finding of OI disappeared in all cases and no signs of acute appendicitis or other disease occurred. All 14 OIs were treated conservatively, with no reported complications. CONCLUSIONS Omental infarction is an underestimated cause of abdominal pain in children accounting for 7% of patients with suspected appendicitis. Ultrasonography is a useful method for the diagnoses and to guide clinical management of OI. Conservative therapy is a safe option for the management of OI.
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Affiliation(s)
- Giovanni Di Nardo
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | | | | | - Carmela Mercogliano
- Pediatric Gastroenterology Units, Santobono-Pausilipon Children Hospital, Naples
| | - Luigi Masoni
- General Surgery Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | - Maria Pia Villa
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | - Pasquale Parisi
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | - Chiara Ziparo
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | - Francesca Vassallo
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
| | - Melania Evangelisti
- From the NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, Sant'Andrea University Hospital, Rome
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Omental Infarction in a Child-Conservative Management as an Effective and Safe Strategy in Diagnosis and Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158057. [PMID: 34360347 PMCID: PMC8345747 DOI: 10.3390/ijerph18158057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/22/2022]
Abstract
Omental infarction (OI) is a rare disease occurring in children. Important risk factors include overweight and obesity. The clinical presentation is often non-specific, and the main symptom is acute abdominal pain. In addition, infarcted omentum may present with fever, anorexia, nausea, vomiting, diarrhea and dysuria. Due to the localisation of the pain, OI should be differentiated from acute appendicitis. The diagnosis of OI is sometimes made intraoperatively, during appendectomy for suspected acute appendicitis. Hence, it is important to state a correct preoperative diagnosis, which is commonly based on abdominal ultrasound and computed tomography. The treatment of OI is still inconclusive. Both conservative and surgical treatments are used. Both methods have their advantages and disadvantages. The decision of which treatment to follow should be multifactorial and include the patient’s clinical condition at the time of admission, the progression or regression of symptoms during hospitalization and laboratory and imaging findings. We present a clinical case of a 9-year-old overweight girl with OI, whose diagnosis was based on imaging diagnostics and enabled conservative treatment with no complications. The case we have described confirms that the conservative treatment is an effective and safe therapy.
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9
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Bianchi F, Leganés Villanueva C, Brun Lozano N, Goruppi I, Boronat Guerrero S. Epiploic Appendagitis and Omental Infarction as Rare Causes of Acute Abdominal Pain in Children. Pediatr Rep 2021; 13:76-85. [PMID: 33562670 PMCID: PMC7931071 DOI: 10.3390/pediatric13010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/28/2021] [Indexed: 02/07/2023] Open
Abstract
Omental infarction and epiploic appendagitis are rare causes of acute abdominal pain in the pediatric population. Radiological evaluation is necessary to establish a specific diagnosis and to differentiate appendicitis from these conditions as they can be often managed conservatively without surgical intervention.
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Affiliation(s)
- Federica Bianchi
- Pediatric Surgery Unit, Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (C.L.V.); (N.B.L.); (I.G.)
| | - Carlos Leganés Villanueva
- Pediatric Surgery Unit, Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (C.L.V.); (N.B.L.); (I.G.)
| | - Núria Brun Lozano
- Pediatric Surgery Unit, Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (C.L.V.); (N.B.L.); (I.G.)
| | - Ilaria Goruppi
- Pediatric Surgery Unit, Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (C.L.V.); (N.B.L.); (I.G.)
| | - Susana Boronat Guerrero
- Pediatric Unit, Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
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10
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Esposito F, Di Serafino M, Mauro A, Mercogliano C, Cocco C, Zenzeri L, Ferrara D, Iacobellis F, Evangelisti M, Ziparo C, Di Nardo G. Not only fat: omental infarction and its mimics in children. Clinical and ultrasound findings: a pictorial review. J Ultrasound 2020; 23:621-629. [PMID: 32623635 PMCID: PMC7588577 DOI: 10.1007/s40477-020-00492-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022] Open
Abstract
Acute abdominal pain in children is the most common cause of emergency department admissions. Omental infarction is a rare cause of acute abdominal pain in this age group, accounting for approximately 15% of cases in children and 0.024-0.1% of cases of surgery for suspected appendicitis at the same age. Its clinical presentation may mimic similar diseases such as acute appendicitis, epiploic appendagitis, and mesenteric panniculitis. Ultrasound is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients and it can be used with confidence in the diagnosis and management of omental infarction in children. In this brief review, we focus on the main ultrasound findings and their diagnostic clue for omental infarction and its mimics.
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Affiliation(s)
- Francesco Esposito
- Department of Emergency Radiology, "Santobono-Pausilipon" Children's Hospital, Naples, Italy
| | - Marco Di Serafino
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy.
| | - Angela Mauro
- Department of Pediatric Emergency, "Santobono-Pausilipon" Children's Hospital, Naples, Italy
| | - Carmela Mercogliano
- Department of Pediatric 2nd Unit, "Santobono-Pausilipon" Children's Hospital, Naples, Italy
| | - Chiara Cocco
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, "Sant'Andrea" University Hospital, Rome, Italy
| | - Letizia Zenzeri
- Department of Pediatric Emergency, "Santobono-Pausilipon" Children's Hospital, Naples, Italy
| | - Dolores Ferrara
- Department of Emergency Radiology, "Santobono-Pausilipon" Children's Hospital, Naples, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy
| | - Melania Evangelisti
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, "Sant'Andrea" University Hospital, Rome, Italy
| | - Chiara Ziparo
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, "Sant'Andrea" University Hospital, Rome, Italy
| | - Giovanni Di Nardo
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, "Sant'Andrea" University Hospital, Rome, Italy
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11
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Alwatari Y, Gerrish A, Ayalew D, Campos GM, Salluzzo JL. Omental infarction with liquefied necrosis after Roux Y gastric bypass: case report and literature review. J Surg Case Rep 2020; 2020:rjaa212. [PMID: 32821367 PMCID: PMC7428737 DOI: 10.1093/jscr/rjaa212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/03/2020] [Accepted: 06/23/2020] [Indexed: 12/19/2022] Open
Abstract
Omental infarction is a rare phenomenon that can be idiopathic or secondary to a surgical intervention. Greater omentum division has been advocated to decrease tension at the gastro-jejunal anastomosis during laparoscopic Roux-en-Y gastric bypass (RYGB). We report a case of omental infraction complicated by liquefied infected necrosis presenting 3 weeks after antecolic antegastric RYGB. The patient underwent laparotomy and subtotal omentectomy with a protracted hospital course due to intra-abdominal abscesses, acute kidney injury and small bowel obstruction that were successfully managed non-operatively. We reviewed the available literature on omental infarction after RYGB, focusing on associated symptoms, possible etiology, timing of presentation, management and propose an alternative technique without omental division.
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Affiliation(s)
- Yahya Alwatari
- Department of Surgery - Division of Bariatric and Gastrointestinal Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Ashley Gerrish
- Department of Surgery - Division of Bariatric and Gastrointestinal Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Dawit Ayalew
- Department of Surgery - Division of Bariatric and Gastrointestinal Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Guilherme M Campos
- Department of Surgery - Division of Bariatric and Gastrointestinal Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennifer L Salluzzo
- Department of Surgery - Division of Bariatric and Gastrointestinal Surgery, Virginia Commonwealth University, Richmond, VA, USA
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12
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Chen YC, Huang SY, Chou CM. Primary omental abscess in children presenting with acute abdomen. Asian J Surg 2020; 43:868-869. [PMID: 32540155 DOI: 10.1016/j.asjsur.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/10/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yi-Chia Chen
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Sheng-Yang Huang
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Man Chou
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
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13
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Esposito F, Ferrara D, Schillirò ML, Grillo A, Diplomatico M, Tomà P. "Tethered Fat Sign": The Sonographic Sign of Omental Infarction. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1105-1110. [PMID: 32035686 DOI: 10.1016/j.ultrasmedbio.2020.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/21/2019] [Accepted: 01/08/2020] [Indexed: 06/10/2023]
Abstract
Our purpose is to describe the ultrasound sign for a correct non-invasive diagnosis of omental infarction in children. From January 2014 to December 2018, a total of 234 children (109 boys and 125 girls, age range 3-15 y) with acute right-sided abdominal pain, admitted to our hospital with a presumptive diagnosis of acute appendicitis, were prospectively evaluated. In all patients, abdominal ultrasound was performed, and the omental fat was always evaluated. In 228 patients, the omental fat resulted to be normal or hyperechogenic, never tethered, and they results affected by other causes of abdominal pain different from omental infarction (such as appendicitis, pancreatitis, urolithiasis and others). In the remaining 6 children, we found a hyperechoic mass between the anterior abdominal wall and the ascending or transverse colon in the right abdomen quadrant, suggesting the diagnosis of omental infarction. This subhepatic mass was always tethered to the abdominal wall, motionless during respiratory excursions. We named this finding the "tethered fat sign." The diagnosis was confirmed with laparoscopy in 4 children. The other 2 children were treated with conservative therapy. In these 2 patients, a sonographic follow-up was performed, showing a progressive reduction in size of the right-sided hyperechoic mass. In conclusion, our study suggests that the presence of the "tethered fat sign" may be an accurate sonographic sign for non-invasive diagnosis of omental infarction in children.
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Affiliation(s)
- Francesco Esposito
- Division of Emergency Radiology, "Santobono" Children Hospital, Naples, Italy
| | - Dolores Ferrara
- Department of Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Assunta Grillo
- Department of Radiology, University of Campania "Luigi Vanvitelli" Naples, Italy
| | - Mario Diplomatico
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy.
| | - Paolo Tomà
- Department of Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Fatty-falciform ligament appendage torsion (F-FLAT): Diagnosis and management in a pediatric patient. Radiol Case Rep 2020; 15:181-185. [PMID: 31890064 PMCID: PMC6923463 DOI: 10.1016/j.radcr.2019.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/11/2019] [Indexed: 11/20/2022] Open
Abstract
Fatty-falciform ligament appendage torsion (F-FLAT) is a rare condition manifested by torsion of the extraperiotoneal fat within the falciform ligament. It is similar to intraperitoneal focal fatty infarctions, including omental infarction and epiploic appendagitis. We report herein the first case of F-FLAT in a pediatric patient that failed conservative management. Ultrasound and CT scan facilitated prompt diagnosis of this rare finding and expedited a quick trial of conservative management. Despite conservative treatment, symptoms persisted for 4 weeks, but resolved after laparoscopic single-site surgical resection. In this report, we discuss the clinical features, key radiographic findings, and treatment options for this unique condition. This is only the third reported pediatric case of F-FLAT in the literature, and the first pediatric case to require surgical resection.
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15
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The Impact of Pathological Criteria on Pediatric Negative Appendectomy Rate. J Pediatr Surg 2019; 54:1794-1799. [PMID: 30685199 DOI: 10.1016/j.jpedsurg.2018.10.106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/21/2018] [Accepted: 10/28/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Negative appendectomy rate (NAR) is a quality metric used in the surgical management of appendicitis. The rates of negative appendectomy (NA) in children range anywhere from 1% to 40% in the literature. Many reports do not provide clear pathological definitions for either appendicitis or NA on which they base their calculation of NAR. We reviewed our experience with pediatric appendectomy and the pathological spectrum encompassed within our definition of a NA and examined how the pathologic definition impacts our hospital's NAR. METHODS A retrospective review from 2012 to 2016 in a single institution identified 1676 children that underwent appendectomy. Average age was 11.4 (2-18 years). Patient demographics, clinical outcomes and pathological findings were collected. At our institution, appendicitis is defined as the presence of transmural acute inflammation in the appendix and those patients without this finding have been considered to have had a negative appendectomy. RESULTS 1435 patients underwent appendectomy for presumed appendicitis. The rate of pathologically diagnosed appendicitis was 91.1% (1307/1435) and as such, the NAR was 8.9% (128/1435). Review of the pathology of the NA cohort identified 67/128 (52.3%) patients with completely normal pathology. The remaining 61 patients displayed some sort of pathological abnormality including malignancy (n = 2), fecaliths (n = 9), pinworms (n = 3), granuloma (n = 2), fibrous obliteration (n = 4), isolated periappendiceal inflammation (n = 1), and acute inflammation confined to the mucosa (n = 40). Exclusion of these patients with abnormal pathology decreased the NAR to 4.6%. Patients with pathological abnormalities of the appendix other than transmural inflammation had a higher rate of 30-day readmission than patients with acute appendicitis (8.2% versus 4.5% p < 0.01). CONCLUSION Pediatric NAR is dependent upon the pathological definition of appendicitis and negative appendectomy. Institutional variation in definition may explain discrepancies in the literature. By example, including only those that show "the absence of inflammation or other appendiceal pathology" would decrease our NAR by 50%. This study calls into question the interpretation of interhospital NAR and the use of NAR as a quality metric in the management of appendicitis. Retrospective comparative study: Level III evidence.
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Omental Infarction with Acute Appendicitis in an Overweight Young Female: A Rare Presentation. Case Rep Surg 2019; 2019:8053931. [PMID: 31093415 PMCID: PMC6476035 DOI: 10.1155/2019/8053931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 11/21/2022] Open
Abstract
Omental infarction is an uncommon cause of acute abdomen but one that clinically mimics more serious and common causes of acute abdomen like appendicitis and cholecystitis. Historically, it was diagnosed only intraoperatively during surgery for presumed appendicitis or other causes of acute abdomen. But with the increase in the use of imaging, especially abdominal computed tomography (CT) scan in the work-up for acute abdomen, more cases of omental infarction are being diagnosed preoperatively. This has also led to the observation that omental infarction is a self-limiting condition which can be managed conservatively. Currently, conservative management and surgery are the only treatment options for omental infarction with no consensus as to the best treatment modality. Having a patient with both acute appendicitis and omental infarction simultaneously is extremely rare with only two reported cases in the literature thus far. Here, we present a 10-year-old obese female who presented to our hospital with acute abdomen and was found to have acute appendicitis and omental infarction. The patient underwent laparoscopic appendectomy and resection of the infarcted omentum and had uneventful recovery and was discharged on the second postoperative day. In this report, we present a review of current literature on omental infarction and highlight the importance of imaging especially abdominal CT scan in the nonoperative diagnosis and treatment of omental infarction.
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Phalke N, Mehta Z, Das S. Utilization of Imaging to Identify a Benign Condition Mimicking Acute Appendicitis in a Child. J Investig Med High Impact Case Rep 2018; 6:2324709618797989. [PMID: 30186884 PMCID: PMC6120172 DOI: 10.1177/2324709618797989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/20/2018] [Accepted: 08/05/2018] [Indexed: 11/17/2022] Open
Abstract
One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and imaging findings of and another closely related condition—epiploic appendagitis. It is important to differentiate appendicitis from these 2 conditions as they can be often managed medically without surgical intervention.
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Affiliation(s)
- Neelam Phalke
- University of Nevada, Reno, NV, USA.,Current affiliation: Department of Otolaryngology, Louisiana State University School of Medicine, New Orleans, LA, USA
| | | | - Samrat Das
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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18
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Diagnosis and management of omental infarction in children: Our 10 year experience with ultrasound. J Pediatr Surg 2018; 53:1360-1364. [PMID: 29550035 DOI: 10.1016/j.jpedsurg.2018.02.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 01/24/2018] [Accepted: 02/03/2018] [Indexed: 02/07/2023]
Abstract
AIM To review children with Omental Infarction (OI) and the role of Ultrasound Scan (US) in its diagnosis and management. METHODS Cases of OI were identified retrospectively from 2004 to 2014 through screening of admission coding, pathology databases and radiology records. Demographic, clinical and pathological data were extracted from case records. MAIN RESULTS 30 cases were identified (17 male, 13 female). Mean age was 10.7years (range 3.5-17.2). The majority of the patients were grossly overweight, with 83.3% of patients weighing greater than the mean for their age. All patients underwent at least one US, 4 had a repeat US and 1 patient also had a CT to rule out appendicitis after a US demonstrating OI. OI was demonstrated in 26 initial USs; in 4 cases initial USs were negative but repeat USs correctly detected OI. In 34 USs the appendix was identified on 20 occasions (15 normal, equivocal in 5). 13 patients underwent surgery, while 17 were managed nonoperatively; 7 underwent omentectomy only, 5 had omentectomy plus appendicectomy and 1 underwent appendicectomy only. All 12 omentectomy specimens were confirmed as OI histologically while none of the 6 appendices showed inflammation histologically. There were no postoperative complications. CONCLUSION In a large series we have demonstrated the efficacy of US in the diagnosis and management of OI in children. To our knowledge this is the largest series of its kind to date. No patient with OI was incorrectly diagnosed with acute appendicitis or vice versa. LEVEL OF EVIDENCE Level IV. TYPE OF STUDY Retrospective Case Series.
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19
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Nijkamp JLG, Gerretsen SC, Stassen PM. Left-sided omental infarction: a rare cause of abdominal pain, discovered by CT scan. BMJ Case Rep 2018; 2018:bcr-2017-224138. [PMID: 29739764 DOI: 10.1136/bcr-2017-224138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Omental infarction in adults is a rarely occurring phenomenon, with left-sided omental infarction being even more seldom. The importance of this case report lies in raising awareness of the diagnosis omental infarction as a cause of acute abdomen among doctors who work in the emergency department, in order to prevent unnecessary surgical interventions as conservative treatment generally solves the problem. Omental infarction is the result of vascular obstruction and ends in tissue ischaemia. Because of the rich vasculature of the greater omentum, anastomoses reorganise the vascularisation, which explains the mostly benign course of omental infarction. By adding omental infarction to the list of differential diagnoses in patients who present with acute abdominal pain, future management of patients with an acute abdomen can be adjusted for the optimal approach to not overlook any surgery-requiring diagnosis as well as to prevent overtreatment.
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Affiliation(s)
- Jamie L G Nijkamp
- Internal Medicine, Maastricht Universitair Medisch Centrum+ Interne Geneeskunde, Maastricht, The Netherlands
| | - Suzanne C Gerretsen
- Radiology, Maastricht Universitair Medisch Centrum +, Maastricht, The Netherlands
| | - Patricia M Stassen
- Internal Medicine, Maastricht Universitair Medisch Centrum+ Interne Geneeskunde, Maastricht, The Netherlands
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20
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Lindley SI, Peyser PM. Idiopathic omental infarction: One for conservative or surgical management? J Surg Case Rep 2018; 2018:rjx095. [PMID: 29599961 PMCID: PMC5868192 DOI: 10.1093/jscr/rjx095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 02/26/2018] [Indexed: 11/14/2022] Open
Abstract
Idiopathic omental infarction (IOI) is a rare cause of right-sided abdominal pain, mimicking serious surgical pathology. It occurs in <4 in 1000 cases of appendicitis. IOI can be a challenge to diagnose, as features may mimic appendicitis, and therefore in young patients, may only be discovered on laparoscopy. CT features can be diagnostic, but due to its rarity the diagnosis may be unclear. The literature supports both conservative management and surgical management (to expedite symptom resolution). We present a case of IOI and discuss our management and learning from the case. We discuss the utility of CT radiology, conservative management and the benefits of non-resection management, even at laparoscopy.
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Affiliation(s)
- Steve I Lindley
- The Royal Cornwall Hospital NHS Trust, 2 Penventinnie Lane, Treliske, Truro TR1 3LQ, UK
| | - Paul M Peyser
- The Royal Cornwall Hospital NHS Trust, 2 Penventinnie Lane, Treliske, Truro TR1 3LQ, UK
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21
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Tepeneu N, Tarmann R, Sinzig M, Fasching G. Primary segmental omental infarction as a rare cause of acute abdominal pain in childhood. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Elgharbawy F, Salameh K, Al Rayes T, Abdelgadir IS. Pediatric case of acute right-sided abdominal pain: diagnosis is not always appendicitis. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2017; 8:69-71. [PMID: 29388616 PMCID: PMC5774598 DOI: 10.2147/phmt.s133409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Omental infarction (OI) is a rare cause of acute abdominal pain occurring in 0.1% of children, which is typically diagnosed during surgery for suspected appendicitis. We present the case of a 7-year-old Pakistani girl. She presented with acute, severe, progressive, right-sided abdominal pain, which was present for 12 hours before presentation. No constitutional symptoms such as fever, anorexia, nausea or vomiting were present. Clinical examination revealed an adequately growing child following the 50th centile. She had severe generalized abdominal tenderness with rebound tenderness and guarding, mainly on the right lower abdominal quadrant, with all other system examinations normal. She had mildly increased inflammatory markers, and her initial abdominal ultrasound scan result was within normal limits. She had laparoscopic surgery following a diagnosis of suspected acute appendicitis; however, an intraoperative diagnosis of OI was made. This was later confirmed by histopathology. This case report highlights the importance of including OI in the differential diagnosis list of acute abdominal pain in children, in addition to the importance of computed tomography (CT) as the gold standard tool to aid diagnosis. In the presence of typical symptoms and signs of OI, a CT scan can assist and guide the management of similar cases. This course of action is suggested for the reason that OI typically runs a self-limited course and conservative care may be the most appropriate recommended course of action. Consequently, unnecessary operations could be avoided due to the diagnosis confirmation of studying images.
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Arigliani M, Dolcemascolo V, Nocerino A, Pasqual E, Avellini C, Cogo P. A Rare Cause of Acute Abdomen: Omental Infarction. J Pediatr 2016; 176:216-216.e1. [PMID: 27289499 DOI: 10.1016/j.jpeds.2016.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 05/11/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Michele Arigliani
- Department of Clinical and Experimental Medical Sciences, University Hospital of Udine, Udine, Italy
| | - Valentina Dolcemascolo
- Department of Clinical and Experimental Medical Sciences, University Hospital of Udine, Udine, Italy; University of Trieste, Trieste, Italy
| | - Agostino Nocerino
- Department of Clinical and Experimental Medical Sciences, University Hospital of Udine, Udine, Italy
| | - Enrico Pasqual
- Department of Surgery, University Hospital of Udine, Udine, Italy
| | - Claudio Avellini
- Institute of Pathology, University Hospital of Udine, Udine, Italy
| | - Paola Cogo
- Department of Clinical and Experimental Medical Sciences, University Hospital of Udine, Udine, Italy
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24
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Kumar A, Shah J, Vaidya P. Primary omental gangrene mimicking appendicular perforation peritonitis-A case report. Int J Surg Case Rep 2016; 21:67-9. [PMID: 26945486 PMCID: PMC4802291 DOI: 10.1016/j.ijscr.2016.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 02/17/2016] [Accepted: 02/20/2016] [Indexed: 11/22/2022] Open
Abstract
Patient presented as a case of appendicular perofration with pyoperitoneum leading to localized peritonitis which is a common surgical emergency. Primary omental torsion is a rare diagnosis and very difficult to diagnose at the emergency room. We report a patient with omental torsion and further gangrene of the omentum leading to pyoperitoneum mimicking appendicuar perforation peritonitis. A review of literature is also included.
Introduction Primary omental torsion is a rare cause of acute abdomen in adults and presents with variable signs and symptoms. Establishing a preoperative diagnosis may be difficult in the emergency setting. It is rarely diagnosed preoperatively as it mimics common surgical emergencies such as acute appendicitis, appendicular perforation, acute cholecystitis and perforated peptic ulcers and can lead to the clinical deterioration of patient if missed Presentation of case A 47 years old male was taken to the operating room with a diagnosis of appendicular perforation peritonitis and during surgery was found to have a primary omental gangrene with pyoperitoneum, for which omentectomy and peritoneal lavage was performed. Discussion Torsion of the omentum is a condition in which the organ twists on its long axis to such an extent that its vascularity is compromised. Omental torsion can be primary (idiopathic) or secondary, depending on an underlying cause. Primary omental torsion was first described by Eitel in 1899. However, very few cases have been reported. Our case was a rare case presenting with omental gangrene with pyoperitoneum mimicking appendicular perforation peritonitis. Conclusion Primary omental torsion is a rare diagnosis. A high index of clinical suspicion is required for a preoperative diagnosis. In doubtful cases a CT scan may be helpful. Surgical excision of the omentum remains the treatment of choice; however, conservative management may be attempted in an uncomplicated omental torsion.
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Affiliation(s)
- A Kumar
- Department of Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal.
| | - J Shah
- Department of Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - P Vaidya
- Department of Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal
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26
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Litzau M, Lall MD. Idiopathic left upper quadrant omental infarction: diagnosed and managed conservatively in the ED. Am J Emerg Med 2014; 33:741.e1-2. [PMID: 25537141 DOI: 10.1016/j.ajem.2014.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- Megan Litzau
- University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine
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Omental Infarction: An Unusual Cause of Left-Sided Abdominal Pain. ACG Case Rep J 2014; 1:223-4. [PMID: 26157883 PMCID: PMC4435328 DOI: 10.14309/crj.2014.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 06/10/2014] [Indexed: 11/17/2022] Open
Abstract
Left-sided omental infarction (OI) is rare in both the adult and pediatric patients. To our knowledge, only 2 pediatric cases of a left-sided OI have been reported in the literature. We report a case of an obese 13-year-old male who presented with a 6-day history of intermittent, colicky, left upper quadrant abdominal pain.
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28
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Radiological, clinical and histological correlations in a right segmental omental infarction due to primary torsion in a child. Diagn Interv Imaging 2014; 95:325-31. [DOI: 10.1016/j.diii.2013.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Omental infarction complicated by internal hernia. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2013.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
PURPOSE OF REVIEW Evaluation of the child with acute abdominal pain is challenging because of the wide range of potential diagnoses. Presenting symptoms, clinical examination, and laboratory findings can guide selection of diagnostic imaging. RECENT FINDINGS Intussusception and intestinal malrotation are potentially serious causes of intestinal obstruction, which are best evaluated by ultrasound and upper gastrointestinal series, respectively. Ultrasound has diagnostic importance in the evaluation of multiple diseases, including appendicitis, by potentially decreasing the need for inpatient observation, cholecystitis and complications of gall stones such as pancreatitis, and ovarian diseases. Pelvic inflammatory disease should be considered in evaluation of a teenage girl with lower abdominal pain. Less common causes of acute abdominal pain include ingested foreign bodies, infected congenital anomalies, and perforated peptic ulcer disease. SUMMARY Presenting symptoms and physical examination findings can narrow the number of potential diagnoses in pediatric acute abdominal pain and thereby guide diagnostic imaging selection. Abdominal/pelvic ultrasound, rather than computed tomography scan, is the preferred modality for initial evaluation of many potential causes of pediatric abdominal pain.
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32
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Barai KP, Knight BC. Diagnosis and management of idiopathic omental infarction: A case report. Int J Surg Case Rep 2011; 2:138-40. [PMID: 22096707 DOI: 10.1016/j.ijscr.2011.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 02/21/2011] [Indexed: 10/18/2022] Open
Abstract
A 32 year old man presented to casualty on three occasions in the space of four days, with intermittent, worsening abdominal pain. These symptoms imitated other commoner causes of acute abdomen and the site of onset changed, both factors delaying diagnosis. In due course, computer tomography imaging established findings indicative of omental infarction. Patient was discharged from hospital nine days later, having made a satisfactory recovery following successful conservative treatment. In this report, we evaluate the merits of a similar approach in future instances.
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Affiliation(s)
- Kushal P Barai
- Department of General Surgery, Royal Blackburn Hospital, East Lancashire Hospitals Trust, Blackburn, Lancashire, United Kingdom
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33
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Scabini S, Rimini E, Massobrio A, Romairone E, Linari C, Scordamaglia R, Marini LD, Ferrando V. Primary omental torsion: A case report. World J Gastrointest Surg 2011; 3:153-5. [PMID: 22110847 PMCID: PMC3220728 DOI: 10.4240/wjgs.v3.i10.153] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 09/23/2011] [Accepted: 09/30/2011] [Indexed: 02/06/2023] Open
Abstract
April 22, 2013
As Editor-in-Chief of the World Journal of Gastrointestinal Surgery, it has come to my attention that two articles that have published in our journal are very similar to the content of previously published papers.
Specifically, the two articles:
Scabini S, Rimini E, Massobrio A, Romairone E, Linari C, Scordamaglia R, Marini LD, Ferrando V. Primary omental torsion: A case report. World J Gastrointest Surg 2011 Oct 27; 3(10): 153-5. DOI: 10.4240/wjgs.v3.i10.153. PubMed PMID: 22110847; PMCID: PMC3220728 has a number of very common features to the previously published paper Efthimiou M, Kouritas VK, Fafoulakis F, Fotakakis K, Chatzitheofilou K. Primary omental torsion: report of two cases. Surg Today 2009; 39(1): 64-7. DOI: 10.1007/s00595-008-3794-7. Epub 2009 Jan 8. PMID: 19132472.
Scabini S. Sentinel node biopsy in colorectal cancer: Must we believe it World J Gastrointest Surg 2010 Jan 27; 2(1): 6-8. DOI: 10.4240/wjgs.v2.i1.6 PMID: 21160827; PMCID: PMC2999193 has copied entire paragraphs from two papers by Nicholl M, Bilchik AJ. Is routine use of sentinel node biopsy justified in colon cancer Ann Surg Oncol 2008 Jan; 15(1): 1-3. Epub 2007 Oct 11. PubMed PMID: 17929100 and Bilchik AJ, Compton C. Close collaboration between surgeon and pathologist is essential for accurate staging of early colon cancer. Ann Surg. 2007 Jun; 245(6): 864-6. PMID: 17522510; PMCID: PMC1876950.
Based on my review of the aforementioned articles, these two articles are being retracted.
I have also asked the office of the World Journal of Gastrointestinal Surgery to make it a matter of policy to use routinely anti-plagiarism software to screen all submissions to the journal in the future.
Sincerely,
Timothy M. Pawlik, MD, MPH, PhD
Editor-in-Chief World Journal of Gastrointestinal Surgery
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Affiliation(s)
- Stefano Scabini
- Stefano Scabini, Edoardo Rimini, Andrea Massobrio, Emanuele Romairone, Renato Scordamaglia, Luisito De Marini, Valter Ferrando, Oncologic Surgical Unit, Department of Haemato-Oncology, St Martino Hospital, 16136 Genova, Italy
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Kambouri K, Gardikis S, Giatromanolaki A, Tsalkidis A, Sivridis E, Vaos G. Omental infarction in an obese 10-year-old boy. Pediatr Rep 2011; 3:e22. [PMID: 22053266 PMCID: PMC3207310 DOI: 10.4081/pr.2011.e22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 08/04/2011] [Indexed: 11/30/2022] Open
Abstract
Primary omental infarction (POI) has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US) examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intra-operative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.
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Gosain A, Blakely M, Boulden T, Uffman JK, Seetharamaiah R, Huang E, Langham M, Eubanks JW. Omental Infarction: Preoperative Diagnosis and Laparoscopic Management in Children. J Laparoendosc Adv Surg Tech A 2010; 20:777-80. [PMID: 20704515 DOI: 10.1089/lap.2010.0204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ankush Gosain
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - Martin Blakely
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - Thomas Boulden
- Division of Pediatric Radiology, Department of Radiology, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - John K. Uffman
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - Rupa Seetharamaiah
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - Eunice Huang
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - Max Langham
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
| | - James W. Eubanks
- Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, Tennessee
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