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Omental infarction present with right upper quadrant pain, case report
Khulud Aolayan1, Ghassan Obaid2, Khaled Fadel2
1Department of Surgery, King Fahad Hospital, Medina, Saudi Arabia.
Journal of Surgical Case Reports
|December 6, 2021
Summary
Omental infarction, a rare cause of acute abdomen, presents diagnostic challenges. This case highlights the difficulty in preoperative diagnosis despite imaging, necessitating surgical intervention for this uncommon condition.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Omental infarction is an uncommon cause of acute abdominal pain.
- It results from compromised blood supply to the omentum.
- Consideration in acute abdomen differential diagnosis is crucial.
Observation:
- A morbidly obese 45-year-old male with diabetes mellitus, dyslipidemia, and recent COVID-19 pneumonia presented with severe epigastric and right upper quadrant pain.
- Computed tomography (CT) suggested biliary colic due to gallstones.
- Pain severity was inconsistent with the initial diagnosis.
Findings:
- Diagnostic laparoscopy revealed an incidental finding of a necrotic omental area.
- Excision of the infarcted omentum and cholecystectomy were performed.
- CT imaging did not reveal specific findings indicative of omental infarction preoperatively.
Implications:
- This case underscores the diagnostic challenges of omental infarction, particularly when imaging is inconclusive.
- Laparoscopy can be essential for diagnosing and treating this rare condition.
- Timely surgical intervention can lead to favorable patient outcomes.
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