Li YL, Fan JX, Yang Y, Yao MQ, Jiang YP. Omental torsion diagnosed by abdominal contrast-enhanced computed tomography: A case report. World J Radiol 2025; 17(12): 114398 [DOI: 10.4329/wjr.v17.i12.114398]
Corresponding Author of This Article
Yu-Peng Jiang, Chief Physician, Department of Gastrointestinal Surgery, Tongxiang First People’s Hospital, No. 1918 Jiaochang East Road, Jiaxing 314500, Zhejiang Province, China. 13567321611@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 28, 2025 (publication date) through Dec 29, 2025
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Journal Information of This Article
Publication Name
World Journal of Radiology
ISSN
1949-8470
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li YL, Fan JX, Yang Y, Yao MQ, Jiang YP. Omental torsion diagnosed by abdominal contrast-enhanced computed tomography: A case report. World J Radiol 2025; 17(12): 114398 [DOI: 10.4329/wjr.v17.i12.114398]
Yu-Lian Li, Department of Nursing, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Jin-Xing Fan, Endoscopy Center, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Yong Yang, Min-Quan Yao, Yu-Peng Jiang, Department of Gastrointestinal Surgery, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Co-first authors: Yu-Lian Li and Jin-Xing Fan.
Co-corresponding authors: Min-Quan Yao and Yu-Peng Jiang.
Author contributions: Li YL and Fan JX organized the patient information, generated the data and wrote the manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Yang Y contributed to assessment of imaging examination; Yao MQ and Jiang YP participated in clinical and intellectual discussions related to the article, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained before the article was written.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Peng Jiang, Chief Physician, Department of Gastrointestinal Surgery, Tongxiang First People’s Hospital, No. 1918 Jiaochang East Road, Jiaxing 314500, Zhejiang Province, China. 13567321611@qq.com
Received: September 19, 2025 Revised: October 20, 2025 Accepted: December 12, 2025 Published online: December 28, 2025 Processing time: 99 Days and 1.9 Hours
Abstract
BACKGROUND
Omental torsion (OT) is a rare cause of acute abdomen, it can be difficult to diagnose preoperatively and is frequently misdiagnosed. Computed tomography (CT) is the primary imaging modality for OT. It typically shows the swirl sign. contrast-enhanced CT can better visualize the central vascular structure of the mass, thus improving the diagnostic accuracy for OT. Surgical resection is the mainstay of treatment for OT. Laparoscopy allows direct visualization of the primary torsion site and comprehensive abdominal exploration, thereby decreasing misdiagnoses. It is a safe and reliable approach for OT treatment, which offers the advantages of minimal trauma, mild postoperative pain, and rapid recovery for stylistic precision.
CASE SUMMARY
A 48-year-old man was admitted to our hospital due to lower right abdominal pain for the preceding 70 hours. Physical examination revealed lower right abdominal muscle strain, tenderness, and rebound pain, but no mass was palpable. Contrast-enhanced CT revealed a thickened, blurred omentum with swirling changes in the right abdomen. Laparoscopic exploration and omentectomy were performed in the emergency setting. The procedure revealed 50 mL of dark-red bloody ascites in the pelvis and twisting of the right omentum along its longitudinal axis, with a 10 cm × 8 cm purple-black necrosis at the distal end. Post-surgical pathology revealed omental hemorrhage, degeneration, and necrosis. The patient had an uneventful recovery and was discharged on the fourth postoperative day. During the subsequent nine-month follow-up, he remained asymptomatic.
CONCLUSION
OT is a rare disease that lacks specific clinical manifestations. Abdominal contrast-enhanced CT plays a crucial role in diagnosing OT, and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.
Core Tip: Primary omental torsion is a rare and clinically elusive cause of acute abdomen. This case highlights that contrast-enhanced computed tomography is pivotal for diagnosis by revealing the pathognomonic “swirl sign” of a twisted omental vasculature. Given the risk of rapid necrosis, timely laparoscopic intervention is the gold standard, offering a safe, minimally invasive approach for both definitive diagnostic exploration and curative therapeutic resection, ultimately ensuring excellent patient outcomes.
