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Omental torsion in adults: A clinical twister
Author(s) -
Sammour Khalil Y.,
Abburu Rao S.,
Sammour Tarik
Publication year - 2007
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2007.00340.x
Subject(s) - medicine , radiological weapon , radiology , abnormality , iliac fossa , ultrasound , conservative management , abdomen , computed tomography , torsion (gastropod) , acute abdomen , surgery , psychiatry
Background: Omental torsion is usually diagnosed intraoperatively and resected. Recent literature supports conservative management after diagnosis of omental torsion using radiological imaging. We present the experience of a single institution. Methods: Retrospective review of clinical, laboratory, radiological and operative data were collected from patient case notes. Results: Six patients were identified as cases of omental torsion between January 2003 and May 2005. Abdominal ultrasound was performed in all patients. The abnormality was described in two patients as vaguely defined focal hyperdense mass‐like lesion in the hypochondrium and right iliac fossa. In another two patients, localized small fluid collections were noted. The remaining two studies were reported as normal. Computed tomography scan of the abdomen performed in five patients accurately identified the abnormality as an ill‐defined, relatively hyperdense fatty mass with a typical whorled appearance centred on engorged blood vessels. Four patients underwent surgery and two were successfully managed conservatively. Conclusion: Awareness and careful evaluation of clinical and laboratory findings, coupled with ultrasound and/or computed tomography studies of the abdomen, can make a reliable diagnosis of omental torsion, affording the option of conservative management in some cases.