Omental infarction in an obese 10-year-old boy

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Primary omental infarction (POI) is a rare cause of acute abdominal pain, predominantly seen in adults.
• It is infrequently considered in the differential diagnosis of acute abdominal pain in pediatric patients.
• Obesity may be a contributing factor in pediatric cases.

Observation:

• A 10-year-old obese boy presented with acute right lower abdominal pain.
• Ultrasound (US) suggested acute appendicitis but did not visualize the appendix.
• Surgical exploration revealed omental infarction, not appendicitis.

Findings:

• The case demonstrates a diagnostic challenge where clinical presentation and initial imaging mimicked acute appendicitis.
• Intraoperative findings confirmed primary omental infarction as the cause of pain.
• This highlights the importance of considering less common etiologies in pediatric abdominal emergencies.

Implications:

• Accurate and timely diagnosis of POI is crucial for appropriate management and to avoid unnecessary surgery.
• Increased awareness of POI in pediatric acute abdomen cases is warranted.
• Further research into the specific risk factors and diagnostic nuances of POI in children is needed.