A case of a primary segmental omental infarction in an adult

Kang, Hyoun Goo; Lee, Hyun Jai; Yi, Chea Yong; Na, Gyoung Jun; Baek, Hyun Choul; Kim, Jung Hun; Kim, Sang Hyun

Abstract

A rare primary segmental omental infarction in an adult. Infarction of a part of the greater omentum has been recognized as an uncommon condition that may mimic other acute abdominal conditions, particularly acute appendicitis and acute cholecystitis. The presentation and course are seldom typical of appendicitis or cholecystitis. A greater omental infarction may occur without a recognizable cause, and may be termed "primary" (idiopathic), but in some cases, a cause is discovered, such as; mechanical interference with the blood supply to the omentum secondary to torsion, or systemic disorders such as cardiac, vascular, and hematological disease. The inflammatory necrotic mass resulting from the infarction produces somatic pain at its location in the abdomen. For unknown reasons the infarction occurs most commonly in the right half of the abdomen, especially the lower quadrant. An sign of peritoneal irritation, tenderness, and muscle guarding are the principal findings elicited on palpitation of the abdomen. Occasionally, a point of exquisite tenderness may be detected; this usually corresponds to the site of the infarction. Recognizing the typical imaging featuresan ovoid or cake-like mass in the omental fat with surrouding inflammatory changesof this condition is important, as most cases can be managed without surgery. We report a case of an adult patient with acute abdominal pain who was diagnosed with a right-sided segmental omental infarction.