Omental infarction in children.
OBJECTIVE
To analyze the clinical presentation, radiologic features, management, and outcome in children diagnosed with omental infarction.


METHODS
This was a retrospective chart review of patients diagnosed with omental infarction in a tertiary care pediatric emergency department. Images and reports of the radiologic investigations were re-examined by a staff radiologist and analyzed for sensitivity.


RESULTS
A diagnosis of omental infarction was made in 19 children (mean age, 9.3 +/- 3.5 years). The presentation was acute right lower quadrant pain in 47% of the children and associated gastrointestinal symptoms in 63%. The sensitivity of abdominal ultrasound (US) to detect omental infarction at our institution was 64%, and the sensitivity of abdominal computed tomography was 90%. Fourteen children were treated conservatively without complications after an accurate diagnosis of omental infarction done by imaging examination. Only 5 children underwent surgery based on clinical suspicion of appendicitis.


CONCLUSIONS
Early identification of omental infarction by abdominal US appears to prevent unjustified surgical procedures and reduce the length of hospital stay.
Rimon
Ayelet
A
Division of Paediatric Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Daneman
Alan
A
Gerstle
J Ted
JT
Ratnapalan
Savithiri
S
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007238:Infarction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D009852:Omentum / Q000098:blood supply* / Q000601:surgery*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014463:Ultrasonography / Q000706:statistics & numerical data