Laparoscopic resection for torsion of an omental lipoma presenting as an acute abdomen in a 5-year-old girl

Abstract

Primary tumors of the greater omentum are rare. We report a case of a 5-year-old girl presenting with an acute abdomen who had omental torsion caused by a giant lipoma of the greater omentum, which was diagnosed by a computed tomography scan. Laparoscopy revealed a yellow tumor of the greater omentum with a smooth surface. Tumor excision and partial omentectomy was performed to treat the torsion, and the tumor was retrieved through a 4-cm-wide abdominal incision. Macroscopically, the specimen was 80 × 60 × 25 mm in size and 74.8 g in weight, and histopathological findings were consistent with the diagnosis of lipoma. The present case highlights the possible use of laparoscopic surgery for removing large abdominal lipomas, thus avoiding the drawbacks of laparotomy in terms of postoperative pain and prolonged hospital stay.

Figure 1:

Contrast-enhanced CT scan showed (A) torsion of the omentum, which was seen as linear folds of omental tissue in a concentric pattern that extended from the level of the transverse colon to the right lower abdomen; and (B) a pelvic mass of 6 cm in diameter with the same uniform radiodensity as fatty tissue.

Figure 2:

Laparoscopy revealed a tumor at the right lower border of the greater omentum with a smooth surface. Laparoscopic resection of the necrotic omentum was performed using an ultrasonic coagulation device.

Figure 3:

Histopathological examination of the resected specimen showed that the tumor was composed of mature fat cells (hematoxylin and eosin, original object magnification ×10).