Acute Abdomen Due to Primary Omental Torsion: Case Report

• Published in: The Journal of emergency medicine 2013, Vol.44 (1), p.e45-e48
• Main Authors: Tsironis, Apostolos, MD, Zikos, Nikolaos, MD, Bali, Christina, PhD, Pappas-Gogos, George, MD, Koulas, Spiridon, MD, Katsamakis, Nikolaos, MD
• Format: Article
• Language: English
• Subjects: Abdomen, Acute - diagnosis; acute abdominal pain; Adult; Emergency; Female; greater omentum; Humans; Laparoscopy; Omentum - surgery; primary omental torsion; Torsion Abnormality - diagnosis; Torsion Abnormality - surgery; Treatment Outcome
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2011.06.066

Abstract Background Primary torsion of the greater omentum is an uncommon cause of acute abdominal pain that mainly affects adults in their fourth or fifth decade. It was first described by Eitel in 1899. Since then, more than 300 cases have been reported in the published literature. Clinical presentation and imaging findings are often of limited value in the diagnosis of primary omental torsion (POT). The patients usually undergo laparotomy for “acute appendicitis” or acute abdomen of poorly defined origin. Objectives To provide a detailed description of this rare cause of acute abdomen. Case Report We report a case of POT in a woman of reproductive age and discuss contemporary methods in diagnosis and management of the condition. Conclusion Nowadays, laparoscopy is a safe and effective approach for the diagnosis and management of POT, with the advantages of reduced postoperative pain and hospital stay. Conservative management has also been advocated by some authors in selected patients with a preoperative diagnosis of POT based on computed tomography findings.