[Primary surgical pathology of the epiploon]

Abstract

In the last nine years we have operated upon six children (eight males and two females) with primary omental pathology. The age of our patients ranged from five to eleven years with the exception of a newborn prenatally diagnosed of lymphangioma. All the remaining children had abdominal pain and right iliac tenderness for an average of two days. All had leukocytosis and left shift. Vomiting and fever were present only in one instance. In no case the mass was palpated preoperatively. The initial diagnosis was acute appendicitis in all cases. A patient suffered, one year after operation, a second acute clinical picture and the omental mass could be revealed [correction of decealed] preoperatively. At operation there was free intraperitoneal fluid in six instances (three times bloody, two times clear and one purulent). Surgical findings (nine operations) were: three omental segmental infarctions (primary in two cases and secondary to torsion in one), three segmental epiploitis in two patients (one acute, one chronic, one secondary to foreign body), two cystic lesions (one lymphangioma, one hydatic cyst) and one benign tumor (fibromatosis).