Pediatric omental torsion: A rare radiologic diagnostic challenge

Omental torsion is a rare cause of acute abdomen, with approximately 400 cases reported in the literature, only a few of which were diagnosed preoperatively. The number of reported cases in pediatric patients is relatively limited. Diagnosis is challenging because the nonspecific clinical presentation often mimics other acute abdominal conditions, particularly appendicitis. We report the case of a 15-year-old male who was presented to the emergency department with a 5-day history of abdominal pain. Clinical and laboratory findings suggested an inflammatory process; however, imaging studies demonstrated a normal appendix. Computed tomography revealed the vascular pedicle sign and the whirlpool sign, leading to a preliminary diagnosis of omental torsion. The patient underwent successful laparotomic omentectomy due to persistent severe pain and suspected recurrence despite conservative management. They were discharged on postoperative day 3. Omental torsion should be included in the differential diagnosis of patients presenting with acute abdominal pain. This case highlights the importance of radiological evaluation in pediatric patients, as accurate imaging can inform appropriate clinical management and help avoid unnecessary surgery. Nevertheless, laparoscopic surgery remains a valuable option when conservative management proves ineffective.