Idiopathic segmental infarction of the greater omentum diagnosed by unenhanced multidetector-row CT and treated successfully by laparoscopy.
Idiopathic segmental infarction of the greater omentum is a rare disorder presenting with nonspecific clinical symptoms that may mimic a variety of acute abdominal conditions. We describe the diagnosis and treatment of two patients who had idiopathic infarction of the greater omentum and presented with localized abdominal pain, mimicking acute cholecystitis and acute diverticulitis, respectively. Patients underwent unenhanced multidetector-row computed tomography (CT) examination, which demonstrated the characteristic features of omental infarction, consisting of a heterogeneous density fatty mass, containing hyperattenuating streaks, located in the greater omentum, between the anterior abdominal wall and the colon; a moderate amount of free peritoneal fluid was also present. There were no other pathological abdominal findings. Giving persisting and worsening symptoms, both patients underwent laparoscopy with resection of the necrotic portion of the omentum. Pathology confirmed the preoperative diagnosis. Unenhanced CT allows us to obtain a reliable diagnosis of omental infarction in patients with acute abdominal pain and may help in selecting the appropriate medical or surgical therapy.
Cianci
Roberta
R
Section of Radiological Sciences, Department of Clinical Sciences and Bioimages, G. d'Annunzio University of Chieti, SS. Annunziata Hospital, Via dei Vestini-Colle dell'Ara, 66013 Chieti, Italy.
Filippone
Antonella
A
Basilico
Raffaella
R
Storto
Maria Luigia
ML
D015746:Abdominal Pain; D000328:Adult; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging* / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed