J Korean Soc Radiol.  2017 Sep;77(3):183-186. 10.3348/jksr.2017.77.3.183.

Omental Torsion and Infarction with Right Inguinal Hernia: A Case Report

• Kim YS
• Kim TH

• KMID: 2405733
• DOI: http://doi.org/10.3348/jksr.2017.77.3.183

Abstract

Omental torsion and infarction are rare causes of acute abdominal pain, and it is often difficult to diagnose these conditions preoperatively. There are several reports showing that computed tomography is useful to diagnose these conditions. Here, we report a case of a 59-year-old man with omental infarction due to secondary omental torsion associated with an untreated inguinal hernia. Preoperative computed tomography showed a fatty mass in the right lower quadrant and a right inguinal hernia containing torsion of the greater omentum. He underwent laparoscopic partial omentectomy and herniorrhaphy, and the postoperative course was uneventful.

MeSH Terms

Abdomen, Acute
Abdominal Pain
Hernia, Inguinal*
Herniorrhaphy
Humans
Infarction*
Middle Aged
Omentum
Torsion Abnormality

Figure

• 

  Fig. 1. A 59-year-old man with omental infarction due to secondary omental torsion associated with an untreated inguinal hernia. A. Axial CT scan shows a fatty mass (arrows) with central soft-tissue attenuation and a peripheral halo in the right lower quadrant, adjacent to the sigmoid colon. B-D. On Coronal CT scan (B), a part of the fatty structure extends into the right inguinal hernia sac (arrowheads). The proximal portion of the herniated fatty structure (arrowheads) and the proximal portion of the omental torsion (arrows) are seen (C). A small dot-like soft tissue structure (line) which is suspected to be the torsion knot is noted in the juxta-proximal portion of the herniated omentum with distended venous structure extending into the ovoid-shaped mass with surrounding fat infiltration (arrows) (D). E, F. Laparoscopic finding of the inguinal hernia and infarcted omentum. Defect in the right external inguinal ring (arrows) was found and the greater omentum (arrowheads) entered into the inguinal hernia site (E) and the infarcted omentum (dotted arrows), proximal to the twisted part (F), was seen during surgery.

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