When Omental Infarction Imitates Appendicitis: Advancing Diagnosis with POCUS

A previously healthy 12-year-old boy presented to the paediatric emergency department on three occasions in the space of four days with progressive right iliac fossa pain. His presentation appeared consistent with appendicitis; however, blood tests remained normal at each presentation. Point of care ultrasound (POCUS) revealed significant inflammatory changes in the right lower quadrant along with free fluid. Due to worsening pain and advancing findings on POCUS, the patient underwent a diagnostic laparoscopy which identified a normal appendix but had features consistent with omental infarction. Omental infarction is a rare condition that can mimic appendicitis, with few recorded cases in the literature. This is the first documented case of POCUS being utilised in the evaluation of a child with omental infarction. While the patient's diagnosis was less common than initially suspected, POCUS played a crucial role in guiding timely and effective patient care, highlighting its value in clinical decision-making However, there are indications of lower POCUS sensitivity to fluid overload with a full peritoneum.