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Case Reports
. 2017 Dec 13;9(12):e1940.
doi: 10.7759/cureus.1940.

Omental Infarction: The Great Impersonator

Kevin G Buell  1 , Alexandra Burke-Smith  1 , Vishal Patel  2 , Josef Watfah  2
Affiliations
Case Reports

Omental Infarction: The Great Impersonator

Kevin G Buell et al. Cureus. .

Abstract

A 58-year-old female presented to the emergency department with intermittent right upper quadrant pain and nausea. On examination, the patient was tender and Murphy's sign was elicited. A presumptive diagnosis of acute cholecystitis was made but an ultrasound of the abdomen revealed a thin-walled gallbladder without calculi. A computed tomography (CT) scan of the abdomen and pelvis demonstrated fat stranding involving the greater omentum and the right paracolic gutter. The patient was diagnosed with a focal omental infarction and underwent emergency laparoscopic surgery. Intraoperatively, the thickened and infarcted omental segment was dissected off the abdominal wall, liver, and mesocolon and removed through the umbilical port site using an Endo Catch™ (Covidien Ltd, Dublin, Republic of Ireland). This paper presents a rare case of omental infarction and illustrates how it can mimic the classic presentation of acute cholecystitis. The literature around the incidence, pathogenesis, and management of omental infarction is reviewed and presented to the reader.

Keywords: acute abdomen; acute cholecystitis; omental infarction.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Computed tomography scan - axial view demonstrating fat stranding around the greater omentum.
Figure 2
Figure 2. Intraoperative picture demonstrating an infarcted omentum adherent to the abdominal wall.
See this image and copyright information in PMC

References

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