Conservative Management of Omental Infarction Using Only Analgesia

Omental infarction (OI) is an uncommon and often misdiagnosed cause of acute abdominal pain. Through increasing use of computed tomography (CT) early identification has improved, avoiding unnecessary surgical intervention.

A 49-year-old woman presented with right-sided abdominal pain radiating to the epigastrium. Laboratory tests revealed elevated inflammatory markers while abdominal ultrasound was inconclusive. CT revealed a localized area of fat stranding in the right hypochondrium, consistent with OI. The patient was managed conservatively with analgesia and intravenous fluids. She was discharged pain-free after 4 days of hospitalization. On reassessment three weeks later, she remained asymptomatic with normalized inflammatory markers.

OI should be considered in the differential diagnosis of right-sided abdominal pain. CT is essential for establishing diagnosis, guiding management and avoiding unnecessary surgery. Conservative treatment is safe and effective in most cases, provided patients are closely monitored for clinical deterioration.