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LAPAROSCOPIC MANAGEMENT OF PRIMARY OMENTAL TORSION: A REGIONAL HOSPITAL EXPERIENCE
Author(s) -
Desai D. J.,
Seow H. S.,
Ashraf M.,
Wagner N.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04917_34.x
Subject(s) - medicine , omentectomy , greater omentum , surgery , laparoscopy , abdomen , thrombosis , acute abdomen , general surgery , deep vein , abdominal pain , chemotherapy
Infarction of the greater omentum is a rare entity representing 0.1% of the total laparotomies performed for acute abdomen. Materials and Methods: Prospectively collected data was retrospectively analysed for the last three calendar years from Jan 2006 to Dec 2008. A total of five cases of Primary Omental torsions were identified of which four were managed laparoscopically and one was managed conservatively. Discussion: The cause of Primary (Idiopathic) segmental infraction of the greater Omentum is unknown. The possible mechanisms are arterial micro thrombosis or venous thrombosis secondary to stretching of the Omental veins, and precipitating factors such anomalous arterial supply to the omentum, kinking of vein secondary to increase intra‐abdominal pressure and vascular congestion after large meals have been suggested. Here we present five cases, all males, ranging from ages of 23 to 55 years with a primary presenting complaint of abdominal pain. Only one of these had a previous appendectomy while two had other abdominal surgeries. The working diagnosis was that of an acute abdomen and four of these underwent laparoscopy and Omentectomy. One of them was conservatively managed. Postoperatively there was an immediate relief of pain and the recovery was uneventful with no mortality. Conclusion: The aim of this article is to share our experience in the diagnosis and management of this rare condition successfully with minimally invasive laparoscopic surgery in our regional centre, and a brief review of the literature.