Omental Torsion: An Unusual Cause of Right Iliac Fossa Pain and Role of Laparoscopic Management

Abstract

Omental torsion is a rare cause of acute abdomen. It usually presents with acute onset right-sided abdominal pain. Adult male between 40 and 50 years of age and obesity are the most common risk factor amongst others. Clinical diagnosis is challenging and difficult to differentiate from more common clinical pathologies such as acute appendicitis and/or acute cholecystitis. Transabdominal imagings such as ultrasonography and/or computed tomography are useful showing typical whirl pattern. Advocated management is surgical excision of torted omentum. Herein, we report a case of primary omental torsion in an adult and a review of current literature. The diagnosis was incidental when patient was undertaken for laparoscopic appendectomy. Only the distal edge of right omentum was torted making a fatty mass of 4 × 3 cm lying on the ascending colon that could have been easily missed if open appendectomy was opted. This case not only highlights the importance of considering torted omentum in differential diagnosis of right-sided abdominal pains but also backs the changing practice to laparoscopic approach for management of right iliac fossa pain.




Gastroenterology Research. 2013;6(6):237-239
doi: http://dx.doi.org/10.4021/gr299e