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• W2409303085 abstract "A 3-year-old boy presented with right lower abdominal pain and vomiting for 24 hours. On examination, he was febrile with guarding and rebound tenderness in the right lower abdomen. Laboratory investigations showed leukocytosis of 28.5 × 109/L and a C-reactive protein over 300 mg/L. The child underwent an urgent laparotomy for suspected acute appendicitis. Intraoperatively, a serosanguineous peritoneal effusion and a wide infarction of 5 × 3 cm in the right-inferior greater omentum were identified (Figures 1 and 2). The appendix, gallbladder, and pelvic organs were normal. The affected omentum was removed. Postoperatively, the recovery was uneventful. A thrombophilia screening was negative.Figure 2Histology showing congested vessels, hemorrhage, focal fat necrosis, and fibrinous exudates.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Omental infarction is a rare cause of acute abdominal pain in children. It is caused by a compromise in the blood supply by either torsion of the greater omentum or spontaneous venous thrombosis.1van Breda Vriesman A.C. de Mol van Otterloo A.J. Puylaert J.B. Epiploic appendagitis and omental infarction.Eur J Surg. 2001; 167: 723-727Crossref PubMed Scopus (40) Google Scholar Right epiploic vessels generally are involved, explaining the tipical predilection for right-sided omental infarctions.2Rimon A. Daneman A. Gerstle J.T. Ratnapalan S. Omental infarction in children.J Pediatr. 2009; 155: 427-431Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar A greater incidence in obese, pre-adolescent boys has been reported.3Helmrath M.A. Dorfman S.R. Minifee P.K. Bloss R.S. Brandt M.L. DeBakey M.E. Right lower quadrant pain in children caused by omental infarction.Am J Surg. 2001; 182: 729-732Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar The presentation often mimics acute appendicitis, and most cases are identified only intraoperatively.3Helmrath M.A. Dorfman S.R. Minifee P.K. Bloss R.S. Brandt M.L. DeBakey M.E. Right lower quadrant pain in children caused by omental infarction.Am J Surg. 2001; 182: 729-732Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar Leukocytosis and low-grade fever may be present in a minority of cases.2Rimon A. Daneman A. Gerstle J.T. Ratnapalan S. Omental infarction in children.J Pediatr. 2009; 155: 427-431Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar On ultrasonography scans, the infarct area usually appears as a hyperechoic mass located in the omental fat.4Bachar G.N. Shafir G. Postnikov V. Belenky A. Benjaminov O. Sonographic diagnosis of right segmental omental infarction.J Clin Ultrasound. 2005; 33: 76-79Crossref PubMed Scopus (30) Google Scholar Characteristic computed tomography findings include a heterogeneous fatty mass with hyperintense strikes between the ascending or transverse colon and the abdominal wall.5Grattan-Smith J.D. Blews D.E. Brand T. Omental infarction in pediatric patients: sonographic and CT findings.AJR Am J Roentgenol. 2002; 178: 1537-1539Crossref PubMed Scopus (63) Google Scholar When the diagnosis is obtained preoperatively, conservative management is feasible because the condition usually is benign and self-limiting within 10-15 days.2Rimon A. Daneman A. Gerstle J.T. Ratnapalan S. Omental infarction in children.J Pediatr. 2009; 155: 427-431Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar Otherwise, some authors advocate for the surgical resection of the affected omentum to expedite clinical recovery and to reduce the risk of secondary abscess formation.6Loh M.H. Chui H.C. Yap T.L. Sundfor A. Tan C.E. Omental infarction–a mimicker of acute appendicitis in children.J Pediatr Surg. 2005; 40: 1224-1226Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar, 7Balthazar E.J. Lefkowitz R.A. Left-sided omental infarction with associated omental abscess: CT diagnosis.J Comput Assist Tomogr. 1993; 17: 379-381Crossref PubMed Scopus (70) Google Scholar" @default.
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• W2409303085 date "2016-09-01" @default.
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• W2409303085 title "A Rare Cause of Acute Abdomen: Omental Infarction" @default.
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