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Sonographic appearance of omental infarction in children
A E Schlesinger1, S R Dorfman, R M Braverman
1Edward B. Singleton Diagnostic Imaging Services, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin St./MC2-2521, Houston, TX 77030, USA.
Insights
Omental infarction, a rare condition, presents specific ultrasound findings in children, though these can be subtle or masked by other signs, impacting diagnosis.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
- Abdominal Ultrasound
Background:
- Omental infarction imaging in children is underrepresented in medical literature.
- Previous reports primarily focus on adult cases.
Purpose of the Study:
- To define the sonographic characteristics of omental infarction in pediatric patients.
- To correlate imaging findings with clinical and pathological data.
Main Methods:
- Retrospective review of sonographic images from nine children with surgically confirmed omental infarction.
- Correlation with clinical presentation, operative notes, and pathology reports.
Main Results:
- Sonography revealed focal, moderately increased echogenicity in the omental fat in seven children.
- This finding was isolated in four cases; in three, it contributed to incorrect preoperative diagnoses.
- Two patients did not exhibit the characteristic echogenicity finding.
Conclusions:
- Moderately increased echogenicity in the omental fat is a key sonographic feature of omental infarction in children.
- This finding, while relatively unique, may be absent or obscured by other sonographic findings, challenging preoperative diagnosis.
Background:
Omental infarction has been previously reported in the adult surgical and imaging literature; however, the imaging features of this entity in children have received little attention.
Objective:
The purpose of our study was to identify the sonographic features of omental infarction in nine children who had preoperative sonography and surgically proven omental infarction.
Materials And Methods:
Sonographic images were reviewed and correlated with clinical information obtained from the patients' medical records, including clinical presentation, operative notes, and pathology reports.
Results:
In seven of the children, sonography demonstrated a focal area of moderately increased echogenicity in the omental fat in the right abdomen (a previously described finding in omental infarction). This was an isolated finding in four of these cases. In the three cases where this was not an isolated finding, the more complex sonographic appearance led to incorrect preoperative imaging diagnoses. This finding of increased echogenicity in the omental fat was not present in the two remaining patients.
Conclusion:
Our study confirms that foci of moderately increased echogenicity in the omentum of the right abdomen, a sonographic finding described in omental infarction in a large series in adults (and in a single prior case report in children), can be seen in children as well. However, although this is a relatively unique finding, it may be absent in some cases or may be seen in conjunction with other sonographic findings which may preclude the correct preoperative sonographic diagnosis.
