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Omental torsion: CT features.

J Kim¹, Y Kim, O K Cho

¹Department of Diagnostic Radiology, Hanyang University Kuri Hospital, Hanyang University College of Medicine, 249-1 Kyomoon-Dong, Kuri City, Kyunggi-Do, 471-701, South Korea.

Abdominal Imaging

|May 12, 2004

Summary

Omental torsion is a rare surgical emergency causing right upper quadrant pain. Computed tomography revealed a characteristic whirling pattern, confirming the diagnosis of omental infarction.

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Area of Science:

Gastroenterology
Surgical Pathology
Radiology

Background:

Omental torsion is an uncommon cause of acute abdominal pain, often mimicking other conditions like acute cholecystitis.
Early diagnosis is crucial for effective management and to prevent complications.

Observation:

A 33-year-old male presented with right upper quadrant pain, initially suspected as acute cholecystitis.
Abdominal computed tomography (CT) demonstrated a distinct "whirling" pattern of fatty streaks and vessels in the greater omentum.

Findings:

Surgical exploration confirmed omental infarction due to torsion.
The CT findings were pathognomonic for omental torsion, correlating with surgical and pathological evidence.

Implications:

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This case highlights the importance of recognizing the specific CT "whirling" sign for diagnosing omental torsion.
Accurate and timely diagnosis via imaging can prevent unnecessary surgeries for conditions with similar presentations.
Omental torsion should be considered in the differential diagnosis of acute abdominal pain, particularly when CT shows characteristic imaging findings.