Omental infarction (OI) is a surgical abdominal disease that is not common in adults and is very rare in children. Similar to various acute abdominal pain diseases including appendicitis, diagnosis was previously achieved by diagnostic laparotomy but more recently, ultrasonography or computed tomography (CT) examination has been used.

A 6-year-old healthy boy with no specific medical history visited the emergency room with right lower abdominal pain. He underwent abdominal ultrasonography by a radiologist to rule out acute appendicitis. He was discharged with no significant sonographic finding and symptom relief. However, the symptoms persisted for 2 more days and an outpatient visit was made. An outpatient abdominal CT was used to make a diagnosis of OI. After laparoscopic operation, his symptoms resolved.

In children’s acute abdominal pain, imaging studies should be performed for appendicitis and OI.

• Omental infarction
• Children
• Ultrasonography
• Computed tomography
• Case report

Omental infarction (OI) is a rare cause of acute abdominal pain that is often missed out. Due to its non-specific presentation can mimic other commoner conditions such as acute appendicitis, acute diverticulitis, and tuberculosis abdomen.

We present a 42-year-old gentleman with trisomy 21 presenting right iliac fossa pain. Examination revealed tenderness in the right lower quadrant and blood parameters showed leucocytosis. With an initial impression of acute appendicitis, the patient was subjected to surgery. Intraoperatively, there were abnormalities to the omentum suggestive of OI, resulting in partial omentectomy. Symptom resolution occurred immediately and the patient was discharged early.

OI is a rare cause of acute abdomen that can mimic other abdominal pathologies. In trisomy 21 patients who present with acute abdomen, thorough assessments including preoperative imaging are advisable. Diagnostic laparoscopy is recommended as OI can be managed via minimally invasive surgery, hence ensuring good surgical outcomes.

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Omental infarction (OI) is a rare cause of acute abdominal pain that is often misdiagnosed, especially among those who present with right iliac fossa pain.

• acute abdomen
• non‐operative management
• omental torsion

• Cuerpos extraños
• Diverticulitis
• Ecografía
• Endometriosis
• Foreign bodies
• Gastrointestinal perforation
• Gastrointestinal tract
• Hernia
• Intestinal obstruction
• Isquemia mesentérica
• Mesenteric ischemia
• Obstrucción intestinal
• Perforación gastrointestinal
• Tracto gastrointestinal
• Ultrasonography
• Vasculitis

• Acute abdominal pain
• Computed tomography
• Conservative treatment
• Omental infarction
• Surgical treatment

• Children
• Inflammation
• Omental infarction
• Omental thickening
• Ultrasound

• Abdominal Pain/etiology
• Adolescent
• Child
• Child, Preschool
• Conservative Treatment
• Diagnosis, Differential
• Female
• Humans
• Infarction/diagnostic imaging
• Infarction/pathology
• Infarction/surgery
• Infarction/therapy
• Inflammation/diagnostic imaging
• Intra-Abdominal Fat/diagnostic imaging
• Male
• Omentum/blood supply
• Omentum/diagnostic imaging
• Prospective Studies
• Sensitivity and Specificity
• Ultrasonography

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and imaging findings of and another closely related condition—epiploic appendagitis. It is important to differentiate appendicitis from these 2 conditions as they can be often managed medically without surgical intervention.

• appendagitis
• appendicitis
• inflammation
• omental infarct

• Humans
• Ischemia/diagnosis
• Ischemia/therapy
• Omentum/blood supply

• abdominal pain
• general surgery
• pediatrics

Adipose tissue does not belong to the most favorite structures to be visualized by ultrasound. It is not, however, free from various pathologies. The aim of this paper is to make abdominal cavity examiners more familiar with non-cancerous lesions found in intra-abdominal fat. The main focus is lesions that are rarely discussed in the literature. Visceral adiposity is one of important pathogenetic factors contributing to cardiovascular events, metabolic syndrome and even certain neoplasms. That is why this article exposes sonographic features that are the most characteristic of these lesions. The value of ultrasonography in the diagnosis of this pathology is underestimated, and a number of US scan reports do not reflect its presence in any way. Moreover, the article discusses more and more common mesenteritis, the lack of knowledge of which could pose difficulties in explaining the nature of symptoms reported by patients. Furthermore, this review presents lesions referred to in the literature as focal infarction of intra-abdominal fat. This section focuses on infarction of the greater and lesser omentum, epiploic appendagitis, mesenteric volvulus and focal fat necrosis resulting from pancreatitis. These lesions should be assessed with respect to the clinical context, and appropriate techniques of ultrasonography should be employed to allow careful determination of the size, shape, acoustic nature and location of lesions in relation to the integuments and large bowel, as well as their reaction to compression with an ultrasound transducer and behavior during deep inspiration. Moreover, each lesion must be obligatorily assessed in terms of blood flow. Doppler evaluation enables the differentiation between primary and secondary inflammation of intra-abdominal fat. The paper also draws attention to a frequent indirect sign of a pathological process, i.e. thickening and hyperechogenicity of fat, which sometimes indicates an ongoing pathology at a deeper site. This structure may completely conceal the primary lesion rendering it inaccessible for ultrasound. In such cases and in the event of other doubts, computed tomography should be the next diagnostic step.

• differential diagnosis
• fat necrosis
• intra-abdominal fat
• non-cancerous lesions
• ultrasound imaging

Segmental omental infarction (SOI) is a rare cause of acute abdominal pain. Depending on the site of infarction, it mimics conditions like appendicitis, cholecystitis, and diverticulitis. Before the widespread use of Computed Tomography (CT), the diagnosis was usually made intraoperatively. SOI produces characteristic radiological appearances on CT scan; hence, correct diagnosis using this form of imaging may prevent unnecessary surgery. We present the case of a young woman who was treated conservatively after accurate radiological diagnosis.

• Abdomen, Acute/etiology
• Appendicitis/diagnosis
• Appendix/surgery
• Child
• Diagnosis, Differential
• Female
• Humans
• Male
• Necrosis
• Obesity/complications
• Omentum/pathology
• Omentum/surgery
• Peritoneal Diseases/complications
• Peritoneal Diseases/diagnosis
• Peritoneal Diseases/surgery
• Rare Diseases
• Retrospective Studies
• Risk Factors
• Torsion Abnormality
• Treatment Outcome

Idiopathic segmental infarction of the greater omentum (ISIGO) is an uncommon cause of acute abdomen in children and adults and its etiology is rather vague and speculative. The clinical presentation is usually with atypical acute or subacute abdominal pain. In a number of cases radiologic imaging allows proper preoperative diagnosis and treatment.

We report a case of ISIGO in a 31 year old patient, who presented with acute abdominal pain, nausea, vomiting and leukocytosis. Radiologic investigation was non-specific. The patient underwent surgical resection of the infracted omentum with compete recovery.

ISIGO should be considered in the differential of acute abdomen especially when presentation is atypical and all other causes have been excluded. In cases with non-specific radiologic findings, laparotomy is necessary for proper diagnosis and treatment. Surgical resection of the infracted omentum results in uneventful recovery in the majority of cases.