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Published on: April 21, 2017
Omental infarction in children
Ayelet Rimon1, Alan Daneman, J Ted Gerstle
1Division of Paediatric Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Insights
Omental infarction in children presents with right lower quadrant pain. Early diagnosis via imaging, particularly CT scans, can prevent unnecessary surgery and shorten hospital stays.
Area of Science:
- Pediatric Surgery
- Abdominal Imaging
- Gastroenterology
Background:
- Omental infarction is a rare surgical emergency in children.
- Clinical presentation can mimic appendicitis, leading to diagnostic challenges.
Purpose of the Study:
- To analyze clinical presentation, radiologic features, management, and outcomes of pediatric omental infarction.
- To evaluate the diagnostic accuracy of imaging modalities for omental infarction.
Main Methods:
- Retrospective chart review of 19 pediatric patients diagnosed with omental infarction.
- Re-examination of radiologic images (ultrasound and CT) by a staff radiologist.
Main Results:
- Omental infarction occurred in children with a mean age of 9.3 years.
- Common symptoms included right lower quadrant pain (47%) and gastrointestinal issues (63%).
- Abdominal ultrasound sensitivity was 64%, while CT sensitivity was 90%.
Conclusions:
- Accurate imaging diagnosis of omental infarction can prevent unnecessary appendectomies.
- Early identification through imaging may reduce hospital length of stay.
Objectives:
To analyze the clinical presentation, radiologic features, management, and outcome in children diagnosed with omental infarction.
Study Design:
This was a retrospective chart review of patients diagnosed with omental infarction in a tertiary care pediatric emergency department. Images and reports of the radiologic investigations were re-examined by a staff radiologist and analyzed for sensitivity.
Results:
A diagnosis of omental infarction was made in 19 children (mean age, 9.3 +/- 3.5 years). The presentation was acute right lower quadrant pain in 47% of the children and associated gastrointestinal symptoms in 63%. The sensitivity of abdominal ultrasound (US) to detect omental infarction at our institution was 64%, and the sensitivity of abdominal computed tomography was 90%. Fourteen children were treated conservatively without complications after an accurate diagnosis of omental infarction done by imaging examination. Only 5 children underwent surgery based on clinical suspicion of appendicitis.
Conclusions:
Early identification of omental infarction by abdominal US appears to prevent unjustified surgical procedures and reduce the length of hospital stay.
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