Pseudotumor of the omentum with a fishbone nucleus.
A 23-year-old Japanese man was admitted with a chief complaint of abdominal pain. He was previously healthy, and his past medical history was unremarkable. Local tenderness and rebound tenderness at McBurney's point were elicited. Abdominal roentgenography was non-diagnostic. Ultrasonography and computed tomography showed a tumor with a central core. Based on a diagnosis of appendicitis with omental inflammation or an omental tumor, laparotomy performed. Intraoperatively, no site of gastrointestinal perforation was detected; however, a 5-cm omental granuloma was identified that proved to have a fishbone nucleus on pathological examination. The postoperative course was uneventful, and upper gastrointestinal endoscopy and barium enema were unremarkable. A large solitary omental pseudotumor is rare, and the clinical course in this case was atypical compared with the usual course of intestinal perforation by a foreign body and formation of an intra-abdominal granuloma.
Yamamoto
Takatsugu
T
Department of Surgery, Nakamoto Hospital, Osaka, Japan. takatsugu@msic.med.osaka-cu.ac.jp
Hirohashi
Kazuhiro
K
Iwasaki
Hiroto
H
Kubo
Shoji
S
Tanaka
Yoshinori
Y
Yamasaki
Keiichi
K
Koh
Masae
M
Uenishi
Takahiro
T
Ogawa
Masao
M
Sakabe
Katsu
K
Tanaka
Shogo
S
Shuto
Taichi
T
Tanaka
Hiromu
H
D000328:Adult; D001842:Bone and Bones; D015745:Granuloma, Foreign-Body / Q000175:diagnosis*; D006104:Granuloma, Plasma Cell / Q000175:diagnosis; D006801:Humans; D008297:Male; D009852:Omentum; D010532:Peritoneal Diseases / Q000175:diagnosis*