Related Experiment Video
Updated: Jul 18, 2026
Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling
Published on: February 5, 2019
Primary omental torsion in children: single-center experience of 17 cases
Faling Chen1, Jiangbin Liu2, Feilong Fan1
1Department of General Surgery, Shanghai Children's Hospital, Shanghai JiaoTong University, Shanghai, 200062, China.
Insights
Primary omental torsion (POT) is a rare cause of abdominal pain in children, often affecting overweight boys. Early diagnosis and laparoscopic treatment are key to managing this condition effectively.
Area of Science:
- Pediatric Surgery
- Abdominal Imaging
- Gastroenterology
Background:
- Primary omental torsion (POT) is an uncommon surgical emergency in children, frequently presenting with non-specific abdominal pain.
- Delayed diagnosis of POT can lead to complications and prolonged hospital stays.
Purpose of the Study:
- To analyze the clinical characteristics, diagnostic challenges, and treatment outcomes of pediatric POT cases.
- To identify factors influencing POT diagnosis and treatment to improve future management.
Main Methods:
- Retrospective review of demographic and clinical data from 17 pediatric POT patients treated between 2012 and 2020.
- Analysis of imaging findings (ultrasound, CT) and correlation with surgical and pathological data.
Main Results:
- POT predominantly affected overweight/obese boys (16/17) aged 4-12 years.
- Characteristic CT findings included a fatty mass with a "whirl sign" in the lower abdomen.
- Laparoscopic omentectomy was effective, with a 70.59% preoperative diagnostic accuracy and a low recurrence rate.
Conclusions:
- POT is more prevalent in obese boys and presents with specific imaging features on CT scans.
- Laparoscopy is a safe and effective treatment for pediatric POT.
- Improved awareness of POT's clinical and imaging findings can reduce misdiagnosis.
Objective:
Primary omental torsion (POT) is a rare condition in children often misdiagnosed because of a lack of clinical manifestations. Here we present insights gained from the treatment of pediatric POT cases at a single center over 8 years and summarize some influencing factors found in diagnosis and treatment, in order to reduce the misdiagnosis of POT in children in the future.
Methods:
Demographic and clinical data of 17 children with POT treated in Shanghai Children's Hospital, Shanghai Jiaotong University from June 2012 to December 2020 were reviewed.
Results:
The mean age of the 17 pediatric patients was 7.65 ± 2.12 years (range: 4-12 years), sixteen were male. The average time from the pain onset to operation was 73.82 ± 47.21 h (range: 21-144 h). In 5 cases, the ultrasound scan revealed a low-intensity inflammatory mass in the abdominal cavity. Only 1 of the 17 patients had normal body mass index, while others were overweight or obese. The mean computed tomography (CT) value of the mass in the lower right abdomen was - 58.74 ± 10.32 HU (range: - 70 to - 46 HU), which is close to that of its own abdominal wall fat [- 46.29 ± 9.45 HU (range: - 62 to - 32 HU)]. The location of the mass was located in front of the right colon in ten cases, except for two cases near the ligamentum teres. Five patients had whirl sign on CT images and 8 patients had pelvic fluid. Five cases were diagnosed as acute appendicitis and 12 were diagnosed as POT, the preoperative diagnosis was correct in 70.59% of cases. All 17 patients were treated with laparoscopic omentectomy. The average duration of hospitalization was 5.53 ± 1.12 days (range: 4-8 days). All cases were followed up. 1 case relapsed 8 months post operation, while the remaining cases had no complications.
Conclusion:
POT is rare in children with acute abdominal pain, which is more common in obese boys. The fatty mass in front of colon and between rectus abdominis sheath in CT image is specific, which is helpful for diagnosis of POT. Laparoscopy is an effective method for the treatment of POT in children.
More Related Videos
07:20Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
06:04Author Spotlight: Studying Clinical Characters and Epilepsy Outcomes After Frontal Disconnection in Patients with MOGHE
Published on: August 16, 2024
