Case 6
History:
34 year old patient with acute left lower quadrant abdominal pain
Findings:
Abdominal CT scan showing a small oval shape fatty lesion in the left abdominal region just lateral to the descending colon.
Diagnosis:
Omental infarction (OI).
Discussion:
Omental infarction (OI) is a relatively rare condition and may occur at any age. It is an acute abdominal condition, which is often clinically misdiagnosed as acute appendicitis or divericulitis. Its most common localization is in the right mid or lower abdomen; segmental infarction can be localized anywhere.
Symptoms usually include acute abdominal pain and localized tenderness; laboratory may sometimes show slight elevation of white blood cell count or sedimentation rate. Clinical symptoms gradually disappear when treated with analgesics and, with appropriate diagnosis, unnecessary surgery can be avoided.
CT scans show a fatty lesion. Follow-up examinations typically show a slow decrease in lesion size and disappearance of the lesion over a period of 1–2 months.
References:
- Wiesner W, Kaplan V, Bongartz G. Omental infarction associated with right-sided heart failure. Eur Radiol 2000;10(7):1130–1132.
- Kimber CP, Westmore P, Hutson JM, Kelly JH. Primary omental torsion in children. J Paediatr Child Health 1996;32(1):22–24.
- Puylaert JB. Right-sided segmental infarction of the omentum: clinical, US, and CT findings. Radiology 1992;185(1):169–172.
- Garant M, Taourel P, Fried GM, Bret PM. Thickening of the transverse colon associated with torsion of the greater omentum. AJR Am J Roentgenol 1995;165:1309
