A rare cause of acute abdomen in children: Primary omental torsion

Abstract

Aim: Torsion of the omentum is a rare cause of acute abdomen that may develop due to primary and secondary etiologies. It is included among the differential diagnoses of acute appendicitis. Preoperative diagnosis is difficult because of the absence of specific symptoms. It should be considered if there are no other causes of acute abdomen in laparoscopy or laparotomy. Material and Methods: In this study, we aimed to present our clinical experiences by evaluating the retrospective data of the cases which were operated for acute abdomen and diagnosed as primary omental torsion between 2001-2016 with regards to gender, age, complaint, duration of complaint, physical examination, laboratory and radiological findings, body mass index, complications, additional anomalies, surgical operations and duration of hospitalization. Results: Six patients who had been operated in our clinic within 16 years due to acute abdomen were diagnosed as primary omental torsion. Four of them were male and 2 of them were female. The most common symptom seen in patients was right quadrant pain and the most common physical examination findings were tenderness at right lower quadrant, abdominal guarding, and rebound tenderness. Three patients who were evaluated as normal in abdomen ultrasonography were diagnosed as omentum torsion in computed tomography. Body mass indices (kg/m2) of 3 patients were within upper limits of overweightness and obesity. Right segment of the omentum was torsioned in five patients. All patients underwent omentectomy and appendectomy with laparotomy. Conclusion: Patients who underwent surgery for acute abdomen should undergo exploration for omental torsion especially if the appendix, gallbladder and pelvic organs have retained their normal appearances. 2017 © Logos Medical Publishing. All Rights Reserved.