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Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment
1Department of Diagnostic Radiology, Clinique St. Luc, Rue St. Luc 8, 5004 Bouge, Belgium. bcoulier@belgacom.net
Insights
Segmental omental infarction (SOI) is a rare cause of abdominal pain in children, often mistaken for appendicitis. Early CT imaging can confirm diagnosis and guide conservative treatment, avoiding unnecessary surgery.
Area of Science:
- Pediatric surgery
- Abdominal imaging
- Gastroenterology
Background:
- Segmental omental infarction (SOI) is an uncommon cause of acute right lower quadrant pain in children.
- It is frequently misdiagnosed as appendicitis, leading to potential surgical intervention.
- While conservative management is favored in adults, its role in pediatric cases remains debated.
Observation:
- A 10-year-old boy presented with symptoms mimicking appendicitis.
- Sonography initially raised suspicion for SOI.
- Multidetector computed tomography (CT) provided unambiguous confirmation of the diagnosis.
Findings:
- The case demonstrated typical imaging findings of segmental omental infarction.
- Conservative management was successfully implemented.
- The condition showed a spontaneous favorable evolution under medical treatment.
Implications:
- CT imaging is crucial for accurate diagnosis of SOI in pediatric patients, especially in obese children.
- Accurate diagnosis can prevent unnecessary appendectomies and surgical complications.
- This case supports conservative management as a viable option for pediatric SOI.
Abstract:
Segmental omental infarction (SOI) is an uncommon cause of right lower quadrant pain in children that is often misdiagnosed as appendicitis. During the last decade, imaging findings of SOI have proved to be sufficiently typical to avoid unnecessary surgery in the majority of reported adult patients. The condition has a spontaneous favourable evolution under medical treatment. In children the surgical option remains controversial. We report a typical case of SOI in a 10-year-old boy. The diagnosis was suspected by sonography, unambiguously confirmed by multidetector CT and successfully treated conservatively. This report emphasizes the use of CT in selected acute abdominal situations, peculiarly in obese children, to avoid unnecessary surgery.
