Omental Infarction: Laparoscopic Treatment of a Rare Cause of the Acute Abdomen

Lauren J Fischer, MD

Riverview Medical Center, Red Bank, NJ

Introduction: Omental infarction is a rare entity which occurs because of focal torsion or lack of blood flow to a portion of the omentum. Signs and symptoms can mimic other acute intra-abdominal conditions. Although a benign condition, typical symptoms are severe and can prolong return to activities of daily living for many weeks.

Case Description: A healthy 36 year old male presented with 2 days of severe periumbilical pain 9 years after repair of an umbilical hernia. On examination, the patient was stable but with focal peritonitis just above the umbilicus. There was no recurrent hernia. CT scan with contrast demonstrated hyperemia and inflammation of the omentum in the midline without hernia or other bowel abnormality. Conservative therapy for omental infarction was initiated with fluids and anti-inflammatories, but with no improvement. Laparoscopic partial omentectomy was then performed with full relief of the patient’s pain immediately after surgery. Pathology demonstrated omental congestion. The patient returned to work 3 days after discharge.

Conclusions: Omental infarction should be considered in the differential diagnosis of the acute surgical abdomen. Laparoscopic partial omentectomy is a safe and effective treatment which may lead to improved outcomes when conservative therapy fails.

Session: Poster Presentation

Program Number: P517

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